Individual
DR. SAMATA BASANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
210 W JOHN CARPENTER FWY STE 100, IRVING, TX 75039-2003
(469) 291-0770
(888) 443-9001
Mailing address
210 W JOHN CARPENTER FWY STE 100, IRVING, TX 75039-2003
(469) 291-0770
(888) 443-9001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
068176
GA
207R00000X
Internal Medicine Physician
P5776
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
P5776
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3461097 01
—
TX
01
—
414064YSFZ
MEDICARE PTAN
TX
Enumeration date
07/13/2012
Last updated
09/22/2025
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