Basile, Myrtha
Basile, Myrtha is an individual health care provider with primary practice located at 721 Clinic Dr Ste A, Tyler TX 75701-2043. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Basile, Myrtha can be contacted via phone (903) 592-6152.Contact Information
Primary practice address
721 Clinic Dr Ste A
Tyler TX 75701-2043
Phone: (903) 592-6152
Fax: (903) 526-0629
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | L6778 | Texas |
Profile Details
| NPI number | 1083619704 |
|---|---|
| LBN Legal business name | Basile, Myrtha |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Jul 18th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083619704 | NPPES |
| Texas | Other | 8J8440 | BLUE CROSS BLUE SHIELD |
| Texas | MEDICAID | 1618910-01 | BLUE CROSS BLUE SHIELD |
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