Basic Information
| Provider Information | |||||||||
| NPI: | 1508054552 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BASSEM MAXIMOS, M.D., MPH, P.A. | ||||||||
| LastName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | MAXIMOS OB/GYN | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 651 N EGRET BAY BLVD FM 270 | ||||||||
| Address2: | SUITE H | ||||||||
| City: | LEAGUE CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326321333 | ||||||||
| FaxNumber: | 8326321777 | ||||||||
| Practice Location | |||||||||
| Address1: | 651 N EGRET BAY BLVD | ||||||||
| Address2: | SUITE H | ||||||||
| City: | LEAGUE CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775732681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326321333 | ||||||||
| FaxNumber: | 8326321777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2007 | ||||||||
| LastUpdateDate: | 09/06/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MAXIMOS | ||||||||
| AuthorizedOfficialFirstName: | BASSEM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8326321333 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.