Provider Demographics
NPI:1902853666
Name:BASU, ABHIJEET GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ABHIJEET
Middle Name:GEORGE
Last Name:BASU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABHIJEET
Other - Middle Name:GEORGE
Other - Last Name:BASU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6400 FANNIN ST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1527
Mailing Address - Country:US
Mailing Address - Phone:713-790-0841
Mailing Address - Fax:713-790-1350
Practice Address - Street 1:5115 FANNIN ST STE 801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5870
Practice Address - Country:US
Practice Address - Phone:713-790-0841
Practice Address - Fax:713-790-9663
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5986207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183946602Medicaid
TX7836843OtherAETNA
TX8S6222OtherBCBS
TXP00449764Medicare PIN
TX7836843OtherAETNA
TX8J2854Medicare PIN
TX8K0659Medicare PIN
TX183946602Medicaid