Baskerville, Stacey

Baskerville, Stacey is an sole proprietor health care provider with primary practice located at 300 Silverleaf Rd Apt 1201 , Sweeny TX 77480-1839. She recently has only one registered license in Emergency Medical Service Providers / Emergency Medical Technician, Intermediate, which is considered as her primary health care specialty. Baskerville, Stacey can be contacted via phone (979) 482-4637.

Contact Information

Primary practice address
300 Silverleaf Rd Apt 1201 Sweeny TX 77480-1839
Phone: (979) 482-4637
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Emergency Medical Technician, Intermediate 146M00000X 139905 Texas

Profile Details

NPI number 1417099565
LBN Legal business name Baskerville, Stacey
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2007
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417099565 NPPES
Texas MEDICAID 1824609

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