Casanova, Mark Andrew

Casanova, Mark Andrew is an individual health care provider with primary practice located at 3600 Gaston Ave Suite 605, Dallas TX 75246-1800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Casanova, Mark Andrew can be contacted via phone (214) 820-9248.

Contact Information

Primary practice address
3600 Gaston Ave Suite 605 Dallas TX 75246-1800
Phone: (214) 820-9248
Fax: (214) 820-9458
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X L6008 Texas
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X L6008 Texas

Profile Details

NPI number 1154332088
LBN Legal business name Casanova, Mark Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jan 28th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154332088 NPPES
Texas MEDICAID 158443501
Texas Other 8G0891
Texas MEDICAID 158443502

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