Organization
DOCTORS REFFINO PEREYRA AND BASILICO FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEOPOLDO MARIO BASILICO MD (PRESIDENT)
(972) 267-6653
Entity
Organization
Contact information
Practice address
7522 CAMPBELL ROAD, SUITE100, DALLAS, TX 75248-1726
(972) 267-6653
(972) 248-3604
Mailing address
7522 CAMPBELL ROAD, SUITE100, DALLAS, TX 75248-1726
(972) 267-6653
(972) 248-3604
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
K6534
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092507501
—
TX
Enumeration date
04/24/2007
Last updated
11/02/2011
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