Provider Demographics
NPI:1669616066
Name:BASORA, JOSE F (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:F
Last Name:BASORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:F
Other - Last Name:BASORA ROVIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:221 W. COLORADO BLVD. PAVILION 2
Mailing Address - Street 2:SUITE 525
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208
Mailing Address - Country:US
Mailing Address - Phone:214-960-5681
Mailing Address - Fax:817-865-6395
Practice Address - Street 1:221 W. COLORADO BLVD. PAVILION 2
Practice Address - Street 2:SUITE 525
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-960-5681
Practice Address - Fax:817-865-6395
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5151207RC0200X, 207RP1001X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine