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Individual

BASAM MUSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3926 HIGHWAY 28 E APT 1501, PINEVILLE, LA 71360-5856
(318) 794-9960
(318) 445-2963
Mailing address
3926 HIGHWAY 28 E APT 1501, PINEVILLE, LA 71360-5856
(318) 794-9960
(318) 445-2963

Taxonomy

Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
660227462
LA
05
664802073
LA
05
802192167
LA
05
84-1906921
LA
Enumeration date
06/05/2019
Last updated
06/05/2019
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