=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336988864
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DONNA L CASEY MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2024
-----------------------------------------------------
Last Update Date | 05/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8210 WALNUT HILL LN STE 218
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75231-4488
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-691-5491
-----------------------------------------------------
Fax | 214-265-0588
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8210 WALNUT HILL LN STE 218
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75231-4488
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-691-5491
-----------------------------------------------------
Fax | 214-265-0588
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DOCTOR
-----------------------------------------------------
Name | DR. DONNA L CASEY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 214-691-5491
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------