Organization
BASANTI VRUSHAB MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY LEE REEVES (OFFICE MANAGER)
(817) 281-4910
Entity
Organization
Contact information
Practice address
1615 PRECINCT LINE RD, STE 101, HURST, TX 76054-3345
(817) 281-4910
(817) 281-3107
Mailing address
1615 PRECINCT LINE RD, STE 101, HURST, TX 76054-3345
(817) 281-4910
(817) 281-3107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M6940
TX
Other
Enumeration date
11/11/2010
Last updated
11/16/2010
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