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Individual

ABDUL BASIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4400 HERITAGE TRACE PKWY STE 208, FORT WORTH, TX 76244-8902
(817) 518-9005
(817) 518-9015
Mailing address
4400 HERITAGE TRACE PKWY STE 208, FORT WORTH, TX 76244-8902
(817) 518-9005
(817) 518-9015

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
Q0409
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720081631
TX
01
8SQ844
BCBS-TX
TX
01
P02674505
MEDICARE RR
TX
Enumeration date
05/24/2005
Last updated
04/20/2023
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