Provider Demographics
NPI:1780606400
Name:BASSEL, PAUL S (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:BASSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W FM 544 STE 250
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4626
Mailing Address - Country:US
Mailing Address - Phone:469-800-2060
Mailing Address - Fax:469-800-2069
Practice Address - Street 1:511 W FM 544 STE 250
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4626
Practice Address - Country:US
Practice Address - Phone:469-800-2060
Practice Address - Fax:469-800-2069
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2926208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ2926OtherSTATE MEDICAL LISCENCE
TX370007264OtherRR MEDICARE
TX105660801Medicaid
TX87W710Medicare ID - Type Unspecified