Healthcare Provider Details

I. General information

NPI: 1063189348
Provider Name (Legal Business Name): BILLIE CASSE DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5452 RENO CORPORATE DR
RENO NV
89511-2250
US

IV. Provider business mailing address

5452 RENO CORPORATE DR
RENO NV
89511-2250
US

V. Phone/Fax

Practice location:
  • Phone: 775-245-2426
  • Fax:
Mailing address:
  • Phone: 775-245-2426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: BILLIE CASSE
Title or Position: OWNER
Credential: DO
Phone: 775-622-2026