Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 20911 | TX |
NPI | 1003998998 |
---|---|
Provider Name | Dr. Joel T Casler |
First Address | Lubbock, TX 79410 |
Second Address | Lubbock, TX 79410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 21/08/2008 |