Provider Demographics
NPI:1881632636
Name:BASS, BARBARA LEE (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LEE
Last Name:BASS
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1601
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-5151
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 1601
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2898208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181829601Medicaid
TX8V4454OtherBLUE CROSS BLUE SHIELD
TX8DY871OtherBLUE CROSS BLUE SHIELD
TX181829602Medicaid
TX181829603Medicaid
TX8V4454OtherBCBS
TX538043ZSWDMedicare PIN
TX181829602Medicaid
TXTXB145723Medicare PIN
TX181829603Medicaid
TX8L14733Medicare PIN