Provider Demographics
NPI:1225200728
Name:BASHA, ANDREW A
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:A
Last Name:BASHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 W HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-6426
Mailing Address - Country:US
Mailing Address - Phone:903-818-2032
Mailing Address - Fax:903-487-2488
Practice Address - Street 1:3700 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-6426
Practice Address - Country:US
Practice Address - Phone:903-818-2032
Practice Address - Fax:903-487-2488
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011318251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health