Provider Demographics
NPI:1235298365
Name:DABAS CANCER INSTITUTE, P.A.
Entity Type:Organization
Organization Name:DABAS CANCER INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BASEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DABAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-656-5100
Mailing Address - Street 1:12501 JUDSON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4103
Mailing Address - Country:US
Mailing Address - Phone:210-656-5100
Mailing Address - Fax:210-656-5125
Practice Address - Street 1:12501 JUDSON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-4103
Practice Address - Country:US
Practice Address - Phone:210-656-5100
Practice Address - Fax:210-656-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3148174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00532TMedicare PIN
TXC23727Medicare UPIN
TXF39494Medicare UPIN