Individual
DR. MARK ANDREW CASANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 GASTON AVE, SUITE 605, DALLAS, TX 75246-1800
(214) 820-9248
(214) 820-9458
Mailing address
3600 GASTON AVE, SUITE 605, DALLAS, TX 75246-1800
(214) 820-9248
(214) 820-9458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L6008
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
L6008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158443501
—
TX
05
—
158443502
—
TX
01
—
8G0891
BCBS
TX
Enumeration date
08/09/2006
Last updated
01/28/2013
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