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NPI 1790579613

NPI 1790579613 : JEFFREY L. CASART : TIOGA, TX

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General NPI Number Information
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    NPI Number           |    1790579613
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    Entity Type          |    Individual 
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    Provider Name        |    JEFFREY L. CASART
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/07/2025
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    Last Update Date     |    04/07/2025
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Provider Practice Location Address
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    Address Line         |    100 S. TEXAS STREET 
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    City                 |    TIOGA
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    State                |    TX
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    Zip                  |    76271
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    Country              |    US
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    Telephone            |    866-656-8384
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    100 S. TEXAS STREET 
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    City                 |    TIOGA
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    State                |    TX
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    Zip                  |    76271
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    Country              |    US
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    Telephone            |    940-902-3384
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    Fax                  |    
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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