MEDICARE: DR. OCTAVIO CASAS DC

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
1	111N00000X	Chiropractor	14501	TX

General Provider Information

NPI Number	:	1871198374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OCTAVIO CASAS DC

Provider Business Mailing Address
First Line	:	9104 JACK PAYNE DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-1695
Country	:	US
Telephone Number	:	806-337-0811
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 OLSEN BLVD STE 105
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-3096
Country	:	US
Telephone Number	:	806-337-0811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2020
Last Update Date	:	04/26/2022

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Directions to “ DR. OCTAVIO CASAS DC” Practice Location

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