Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | H1352 | TX |
NPI | 1215938352 |
---|---|
Provider Name | Daniel Casso |
First Address | Nassau Bay, TX 77058-3683 |
Second Address | Nassau Bay, TX 77058-3683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 26/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E35376 | (02) |