Individual
MICHAEL DAVID BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1244
Mailing address
1320 S UNIVERSITY DR STE 500, FORT WORTH, TX 76107-5732
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
U4467
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2019
Last updated
01/20/2026
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