Provider Demographics
NPI:1881084911
Name:JUMAA, BASEM (CRNA)
Entity type:Individual
Prefix:
First Name:BASEM
Middle Name:
Last Name:JUMAA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3140 LEGACY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9383
Mailing Address - Country:US
Mailing Address - Phone:972-954-1469
Mailing Address - Fax:469-283-2743
Practice Address - Street 1:25440 INTERSTATE 45 N
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386
Practice Address - Country:US
Practice Address - Phone:281-602-8160
Practice Address - Fax:469-283-2743
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127313367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343585101Medicaid
TX8848UJOtherBCBS
TXP01493667OtherRR MEDICARE
TXP01493667OtherRR MEDICARE