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NPI Code Detail

MEDICARE: CASEY FAICHTINGER DO

MEDICARE: CASEY FAICHTINGER DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1386403822
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY FAICHTINGER DO
Provider Business Mailing Address
First Line : 3555 KNICKERBOCKER RD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-7610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3555 KNICKERBOCKER RD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-7610
Country : US
Telephone Number : 325-747-7675
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2024
Last Update Date : 04/30/2026

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