Provider Demographics
NPI:1447208384
Name:DABAS, BASEL (MD)
Entity type:Individual
Prefix:
First Name:BASEL
Middle Name:
Last Name:DABAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12501 JUDSON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LIVEOAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4117
Mailing Address - Country:US
Mailing Address - Phone:210-656-5100
Mailing Address - Fax:210-656-5125
Practice Address - Street 1:12501 JUDSON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-4103
Practice Address - Country:US
Practice Address - Phone:210-656-5100
Practice Address - Fax:210-656-5125
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK3148207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152419101Medicaid
TX1235298365OtherGROUP NPI
TX152419101Medicaid
TXF39494Medicare UPIN