Rafael Gerald Basa

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

774109 Issued in TX

Practice address

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200

Phone

(832) 817-0191

NPI assigned

Nov 7, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1528831948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3083 HERSCHEL AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192025",
            "telephone_number": "832-817-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907200",
            "telephone_number": "832-817-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASA",
        "first_name": "RAFAEL",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "774109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barun Spine, PLLC
• Minal Atul Barve, M.D.
• Stran Barzani, FNP-C
• Sayeh Barzin, D.O.
• Hasti Barzkar, DO
• Berkay Basagaoglu, MD
• Celina Michelle Basaldu
• Teodorico Basallaje, CFA
• Deniz Selda Basci, M.D.
• Teresa Janelle Bascom, M.D.

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.