Organization
CEDAR PARK SURGEONS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE R BASA M.D. (PRESIDENT)
(512) 260-3444
Entity
Organization
Contact information
Practice address
1410 MEDICAL PKWY STE 1, CEDAR PARK, TX 78613-2543
(512) 260-3444
(512) 260-3555
Mailing address
1410 MEDICAL PKWY STE 1, CEDAR PARK, TX 78613-2543
(512) 260-3444
(512) 260-3555
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7029
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020QH
BCBS TX
TX
05
—
190188601
—
TX
Enumeration date
10/09/2007
Last updated
07/22/2024
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