Individual
SHIRA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5303 HARRY HINES BLVD, DALLAS, TX 75390-6338
(917) 327-8453
Mailing address
5303 HARRY HINES BLVD, DALLAS, TX 75390-7208
(917) 327-8453
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
677398-1
NY
363L00000X
Nurse Practitioner
Primary
1084189
TX
363L00000X
Nurse Practitioner
F43175201
NY
363LA2200X
Adult Health Nurse Practitioner
F431752-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
677398-1
LICENSE#
NY
Enumeration date
10/27/2014
Last updated
06/12/2025
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