Casanova, Mark Andrew
Casanova, Mark Andrew is an individual health care provider with primary practice located at 3600 Gaston Ave Suite 605, Dallas TX 75246-1800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Casanova, Mark Andrew can be contacted via phone (214) 820-9248.Contact Information
Primary practice address
3600 Gaston Ave Suite 605
Dallas TX 75246-1800
Phone: (214) 820-9248
Fax: (214) 820-9458
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | L6008 | Texas |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | L6008 | Texas |
Profile Details
| NPI number | 1154332088 |
|---|---|
| LBN Legal business name | Casanova, Mark Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jan 28th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154332088 | NPPES |
| Texas | MEDICAID | 158443501 | |
| Texas | Other | 8G0891 | |
| Texas | MEDICAID | 158443502 |
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