Provider Demographics
NPI:1063199016
Name:BASYE, MICHAEL C MILTION (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C MILTION
Last Name:BASYE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:BASYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:12319 N MOPAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2414
Mailing Address - Country:US
Mailing Address - Phone:512-881-1936
Mailing Address - Fax:
Practice Address - Street 1:12319 N MOPAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2414
Practice Address - Country:US
Practice Address - Phone:512-881-1936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX972619163WE0003X
TX1141971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency