Healthcare Provider Details

I. General information

NPI: 1427163955
Provider Name (Legal Business Name): MICHAEL GERARD CASAGRANDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13628 MICHEL RD
TOMBALL TX
77375-6492
US

IV. Provider business mailing address

13628 MICHEL RD
TOMBALL TX
77375-6492
US

V. Phone/Fax

Practice location:
  • Phone: 281-357-1934
  • Fax: 281-803-5298
Mailing address:
  • Phone: 281-357-1934
  • Fax: 281-357-1230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberK0435
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK0435
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: