Healthcare Provider Details

I. General information

NPI: 1992770002
Provider Name (Legal Business Name): STEVEN LANE CASEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 TURTLE CREEK BLVD SUITE #1101
DALLAS TX
75219-5405
US

IV. Provider business mailing address

PO BOX 122089
FORT WORTH TX
76121-2089
US

V. Phone/Fax

Practice location:
  • Phone: 214-526-1133
  • Fax: 214-526-1136
Mailing address:
  • Phone: 214-526-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberJ4028
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: