Organization
ROBERT L BASS MD PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE MARIE JACKSON (PRACTICE ADMINISTRATOR)
(214) 239-4500
Entity
Organization
Contact information
Practice address
4461 COIT RD, SUITE 107, FRISCO, TX 75035-0521
(972) 712-9408
(972) 712-4493
Mailing address
4461 COIT RD, SUITE 107, FRISCO, TX 75035-0521
(214) 239-4500
(214) 239-4504
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
H6036
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060LP
BCBS
TX
05
—
118580305
—
TX
01
—
P00218438
RAILROAD MEDICARE
TX
Enumeration date
09/04/2007
Last updated
07/10/2008
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