Provider Demographics
NPI:1932252632
Name:RIO GRANDE ORTHOPEDIC CENTER
Entity Type:Organization
Organization Name:RIO GRANDE ORTHOPEDIC CENTER
Other - Org Name:RICK WILLIAM BASSETT, MD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-421-2663
Mailing Address - Street 1:1601 TREASURE HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8910
Mailing Address - Country:US
Mailing Address - Phone:956-421-2663
Mailing Address - Fax:956-421-2418
Practice Address - Street 1:1601 TREASURE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8910
Practice Address - Country:US
Practice Address - Phone:956-421-2663
Practice Address - Fax:956-421-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00998KOtherBLUE CROSS BLUE SHIELD
TX149184702Medicaid
TX00998KMedicare PIN
TXCP4267Medicare PIN
TX149184702Medicaid