Individual provider Active NPI

Micaul Bass

  • Licensed Vocational Nurse
  • Houston, TX
National Provider Identifier
1073146239
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
333095 Issued in TX
Practice address
2926 Barker Cypress Rd Apt 5107
Houston, TX 77084-7939
Phone
(361) 772-7258
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 333095 TX Primary

Addresses

Primary practice location

2926 Barker Cypress Rd Apt 5107
Houston, TX 77084-7939

Mailing address

1155 Dairy Ashford Rd Ste 560
Houston, TX 77079-3035
Phone (713) 799-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
333095TXMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1073146239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 DAIRY ASHFORD RD STE 560",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793035",
            "telephone_number": "713-799-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 BARKER CYPRESS RD APT 5107",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847939",
            "telephone_number": "361-772-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "MICAUL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "333095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.