Provider Demographics
NPI:1639268006
Name:LASSINGER, BRIAN K (PA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:LASSINGER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BAYLOR PLZ
Mailing Address - Street 2:ROOM 404-D MICHAEL E. DEBAKEY DEPT. OF SURGERY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-873-2746
Mailing Address - Fax:713-795-5622
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-873-2230
Practice Address - Fax:713-873-3056
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03715208600000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181032702Medicaid
TX8Y1249OtherBCBS
TX181032701Medicaid
TN8B4661Medicare PIN
TX8Y1249OtherBCBS
Q09286Medicare UPIN
TX181032702Medicaid