Leopoldo M Basilico (NPI# 1508836248, PAC ID# 9537065248) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1508836248 |
| PAC ID by PECOS | 9537065248 |
| Professional Enrollment ID | I20091204000080 |
| Full Name | Leopoldo M Basilico |
| Organization Legal Name | LIVING FOREST COUNTRY EMERGENCY PHYSICIANS PLLC |
| Address |
4920 Ne Stallings Dr Nacogdoches TX 75961-1254 |
| Phone Number | 9365683441 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1972 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1951440494 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450099 | PAMPA REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 | 9365683441 | LIVING FOREST COUNTRY EMERGENCY PHYSICIANS PLLC |
| One Medical Plaza, Pampa, TX 79065-2819 | 8066650801 | SPMG SIGNATURE PAMPA MEDICAL GROUP |
| Organization Legal Name | LIVING FOREST COUNTRY EMERGENCY PHYSICIANS PLLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey G Mcwilliams | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 5100 Loop 500, Center, TX 75935-9751 |
| Ky V Nguyen | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 |
| Christian L Trux | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 |
| David M Brown | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 |
| Street Address |
4920 NE STALLINGS DR |
| City | NACOGDOCHES |
| State | TX |
| Zip | 75961-1254 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nancy J Batzloff | Certified Registered Nurse Anesthetist (crna) | Main Street Anesthesia of Texas Pa | 4920 Ne Stallings Dr, Nacogdoches Medical Center, Nacogdoches, TX 75965-1254 |
| Angela C Thomas Brown | Family Medicine | Stone Fort Inpatient Services Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 |
| Christie P Lathan | Nurse Practitioner | Stone Fort Inpatient Services Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 |
| Niki M Fincher | Certified Registered Nurse Anesthetist (crna) | Main Street Anesthesia of Texas Pa | 4920 Ne Stallings Dr, Nacogdoches Medical Center, Nacogdoches, TX 75965-1254 |
| Ethan Taylor | Certified Registered Nurse Anesthetist (crna) | Main Street Anesthesia of Texas Pa | 4920 Ne Stallings Dr, Nacogdoches Medical Center, Nacogdoches, TX 75965-1254 |
| Jacob J Reinen | Certified Registered Nurse Anesthetist (crna) | Main Street Anesthesia of Texas Pa | 4920 Ne Stallings Dr, Nacogdoches Medical Center, Nacogdoches, TX 75965-1254 |
| Silvia V Bautista | Nurse Practitioner | Stone Fort Inpatient Services Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 |
| Jeffrey W Fidone | Pulmonary Disease | Stone Fort Inpatient Services Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 |
| John Q Nguyen | Internal Medicine | Stone Fort Inpatient Services Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 |
| James R Young | Cardiac Surgery | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1207 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ky V Nguyen | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 |
| Christian L Trux | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 |
| Roger N Collins | Emergency Medicine | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 | |
| David M Brown | Emergency Medicine | Living Forest Country Emergency Physicians Pllc | 4920 Ne Stallings Dr, Nacogdoches, TX 75961-1254 |
| Lawrence Q Robinson | Emergency Medicine | Ess of Nacogdoches LLC | 1204 N Mound St, Nacogdoches, TX 75961-4027 |
| Mary Beth Calme | Diagnostic Radiology | Radiology Consultants of Nacogdoches LLP | 1204 N Mound, Nacogdoches, TX 75961-4027 |
| James Edward Hughes | Certified Registered Nurse Anesthetist (crna) | Youngs Professional Services LLC | 1204 N Mound St, Yps Anesthesia Services, Nacogdoches, TX 75961-4027 |
| Koteshwara R Nadipalli | Family Medicine | Ess of Nacogdoches LLC | 1204 N Mound St, Nacogdoches, TX 75961-4027 |
| Robert Griffith | Nurse Practitioner | Ess of Nacogdoches LLC | 1204 N Mound St, Nacogdoches, TX 75961-4027 |
| Lashonda Evetta Traylor | Nurse Practitioner | Ess of Nacogdoches LLC | 1204 N Mound St, Nacogdoches, TX 75961-4027 |
| Find all physicians in zip 75961 | |||
| City | NACOGDOCHES |
| Zip Code | 75961 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | NACOGDOCHES + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Leopoldo M Basilico.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.