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NPI Code Detail

MEDICARE: DR. DANIEL FREDERICK CASEY M.D.

MEDICARE: DR. DANIEL FREDERICK CASEY M.D.
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
1207Q00000XFamily Medicine PhysicianK2148TX

General Provider Information

NPI Number : 1457340010
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL FREDERICK CASEY M.D.
Provider Business Mailing Address
First Line : PO BOX 911294
Second Line : DALLAS
City : DALLAS
State : TX
Zip : 75391-1294
Country : US
Telephone Number : 817-852-8440
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S MAIN ST
Second Line : FORT WORTH
City : FORT WORTH
State : TX
Zip : 76104-4917
Country : US
Telephone Number : 817-927-1395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 07/08/2007

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