MEDICARE: HARRY PAUL CASMEDES M.D., D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	J7757	TX
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	15898	TX

General Provider Information

NPI Number	:	1013084169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRY PAUL CASMEDES M.D., D.D.S.

Provider Business Mailing Address
First Line	:	1600 W 38TH ST
Second Line	:	SUITE 320
City	:	AUSTIN
State	:	TX
Zip	:	78731-6400
Country	:	US
Telephone Number	:	512-324-3310
Fax Number	:	512-324-3311

Provider Business Practice Location Address
First Line	:	6012 W WILLIAM CANNON DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1980
Country	:	US
Telephone Number	:	512-324-3310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	09/25/2012

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