Provider Demographics
NPI:1881879278
Name:BASILE, JASON L (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:BASILE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:5701 WOODWAY DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-1515
Mailing Address - Country:US
Mailing Address - Phone:713-532-2555
Mailing Address - Fax:713-532-2999
Practice Address - Street 1:5701 WOODWAY DR
Practice Address - Street 2:SUITE 225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1515
Practice Address - Country:US
Practice Address - Phone:713-532-2555
Practice Address - Fax:713-532-2999
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX7968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609133OtherMEDICARE ID
TX605887OtherBLUE CROSS/BLUE SHIELD
TXU72140Medicare UPIN
TX8F2751Medicare PIN