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General NPI Number Information
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NPI Number | 1265481501
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Entity Type | Individual
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Provider Name | DIANA CASE PA
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 301 HIGHWAY 71 W SUITE 111
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City | BASTROP
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State | TX
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Zip | 78602-4105
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Country | US
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Telephone | 515-445-4800
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Fax | 512-308-9649
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Provider Business Mailing Address
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Address Line | 301 HIGHWAY 71 W SUITE 111
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City | BASTROP
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State | TX
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Zip | 78602-4105
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Country | US
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Telephone | 515-445-4800
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Fax | 512-308-9649
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA01874
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License Number State | TX
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