Provider Demographics
NPI:1215962485
Name:BASKIN, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6445 MAIN ST
Mailing Address - Street 2:OPC P24-C026
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1502
Mailing Address - Country:US
Mailing Address - Phone:713-441-3803
Mailing Address - Fax:713-793-1001
Practice Address - Street 1:6445 MAIN ST
Practice Address - Street 2:OPC P24-C026
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1502
Practice Address - Country:US
Practice Address - Phone:713-441-3803
Practice Address - Fax:713-793-1001
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG7485207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120433105Medicaid
TX8R9780OtherBLUE CROSS BLUE SHIELD
TXP01331478OtherRR MEDICARE
TX8GD770OtherBCBS
TX8EA862OtherBLUE CROSS BLUE SHIELD
TX120433106Medicaid
TX8EA862OtherBLUE CROSS BLUE SHIELD
TXB21114Medicare UPIN
TX327642YMVQMedicare PIN
TX8D2599Medicare PIN