Baskaran, Gautam

Baskaran, Gautam is an individual health care provider with primary practice located at 705 E Marshall Ave Ste 5001 , Longview TX 75601-5524. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Baskaran, Gautam can be contacted via phone (903) 315-4551.

Contact Information

Primary practice address
705 E Marshall Ave Ste 5001 Longview TX 75601-5524
Phone: (903) 315-4551
Fax: (903) 315-3415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 2011014212 Missouri
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X Q0003 Texas

Profile Details

NPI number 1679732549
LBN Legal business name Baskaran, Gautam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2008
Last updated Jun 17th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679732549 NPPES
Texas Other P02599916 MCRR
Texas MEDICAID 335691703 MCRR

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