Healthcare Provider Details

I. General information

NPI: 1265336424
Provider Name (Legal Business Name): CASEY THORSEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 W PARMER LN
AUSTIN TX
78727-3901
US

IV. Provider business mailing address

6001 W PARMER LN
AUSTIN TX
78727-3901
US

V. Phone/Fax

Practice location:
  • Phone: 512-249-8316
  • Fax: 866-455-4129
Mailing address:
  • Phone: 512-249-8316
  • Fax: 866-455-4129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number388633
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: