Provider Demographics
NPI:1982179453
Name:ROBERT G BASS, JR. MD PA
Entity Type:Organization
Organization Name:ROBERT G BASS, JR. MD PA
Other - Org Name:TRANSITIONCARE MEDICAL GROUP PLLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MHA
Authorized Official - Phone:210-404-2650
Mailing Address - Street 1:1202 E SONTERRA, STE 701
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-404-2650
Mailing Address - Fax:210-495-0261
Practice Address - Street 1:1202 E SONTERRA BLVD STE 701
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4094
Practice Address - Country:US
Practice Address - Phone:210-404-2650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty