Provider Demographics
NPI:1194901090
Name:C. BOB BASU, M.D., P.A.
Entity type:Organization
Organization Name:C. BOB BASU, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRASEKHAR
Authorized Official - Middle Name:BOB
Authorized Official - Last Name:BASU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-799-2278
Mailing Address - Street 1:9899 TOWNE LAKE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:713-799-2278
Mailing Address - Fax:713-333-2774
Practice Address - Street 1:9899 TOWNE LAKE PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:713-799-2278
Practice Address - Fax:713-333-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1498174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty