Healthcare Provider Details

I. General information

NPI: 1548950983
Provider Name (Legal Business Name): DAMARCUS CAUSEY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LEE ST
WICHITA FALLS TX
76301-1128
US

IV. Provider business mailing address

200 MARTIN LUTHER KING BLVD
WICHITA FALLS TX
76301-1152
US

V. Phone/Fax

Practice location:
  • Phone: 940-766-6306
  • Fax:
Mailing address:
  • Phone: 940-766-6306
  • Fax: 940-766-6504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number41988
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: