Individual
BASEL DABAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12501 JUDSON RD, SUITE 102, LIVE OAK, TX 78233-4103
(210) 656-5100
(210) 656-5125
Mailing address
12501 JUDSON RD, SUITE 102, LIVEOAK, TX 78233-4117
(210) 656-5100
(210) 656-5125
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
K3148
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235298365
GROUP NPI
TX
05
—
152419101
—
TX
Enumeration date
05/04/2006
Last updated
04/07/2009
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