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General NPI Number Information
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NPI Number | 1366454274
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Entity Type | Individual
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Provider Name | CASEY LYNN ANGELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 5117 SUNMORE CIR
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City | MIDLAND
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State | TX
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Zip | 79707
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Country | US
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Telephone | 432-689-2512
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Fax | 432-689-2108
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Provider Business Mailing Address
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Address Line | 5117 SUNMORE CIR
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City | MIDLAND
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State | TX
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Zip | 79707-5124
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Country | US
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Telephone | 432-689-2512
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Fax | 432-689-2108
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA04642
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License Number State | TX
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