1992998959 NPI number — CARMEN CASAS, MD, PA

Table of content: (NPI 1992998959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992998959 NPI number — CARMEN CASAS, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARMEN CASAS, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992998959
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5756 S STAPLES ST
Provider Second Line Business Mailing Address:
STE J1
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78413-3782
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-994-1001
Provider Business Mailing Address Fax Number:
361-994-1004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5756 S STAPLES ST
Provider Second Line Business Practice Location Address:
STE J1
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78413-3782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-994-1001
Provider Business Practice Location Address Fax Number:
361-994-1004
Provider Enumeration Date:
08/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CASAS
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
361-994-1001

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  F3424 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00F43E . This is a "MEDICARE ID-TYPE UNSPECIF" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 83J076 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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