Outlaw, Casey Dawn
Outlaw, Casey Dawn is an individual health care provider with primary practice located at 400 S Loop 336 W , Conroe TX 77304-3302. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Outlaw, Casey Dawn can be contacted via phone (936) 539-4500.Contact Information
Primary practice address
400 S Loop 336 W
Conroe TX 77304-3302
Phone: (936) 539-4500
Fax: (936) 539-4050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 9419T | Texas |
Profile Details
| NPI number | 1689169849 |
|---|---|
| LBN Legal business name | Outlaw, Casey Dawn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2018 |
| Last updated | Jul 19th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689169849 | NPPES |
| Texas | MEDICAID | 433634901 |
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