Bass, Mary Kay

Bass, Mary Kay is an individual health care provider with primary practice located at 855 Montgomery St Dept Of Ob/Gyn, Fort Worth TX 76107-2553. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Bass, Mary Kay can be contacted via phone (817) 927-1065.

Contact Information

Primary practice address
855 Montgomery St Dept Of Ob/Gyn Fort Worth TX 76107-2553
Phone: (817) 927-1065
Fax: (817) 927-1065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 426139 Texas

Profile Details

NPI number 1538240650
LBN Legal business name Bass, Mary Kay
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Sep 26th, 2011 - about 14 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 1538240650 NPPES
Texas Other P00415573 RAILROAD MEDICARE
Texas Other 8N8816 RAILROAD MEDICARE
Texas MEDICAID 044360804 RAILROAD MEDICARE

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