Individual
MARY BASKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13737 NOEL ROAD, SUITE 1400, DALLAS, TX 75240-2004
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5007
(972) 715-5682
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
532629
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C82U
GROUP BCBSTX
TX
05
—
182003701
—
TX
05
—
182003702
—
TX
05
—
182003703
—
TX
01
—
8573UC
BCBSTX
TX
01
—
86685U
BCBS
TX
01
—
P00387530
RAILROAD
TX
Enumeration date
08/23/2006
Last updated
05/21/2014
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