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Individual

MRS. CASEY LYNN ANGELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5117 SUNMORE CIR, MIDLAND, TX 79707
(432) 689-2512
(432) 689-2108
Mailing address
5117 SUNMORE CIR, MIDLAND, TX 79707-5124
(432) 689-2512
(432) 689-2108

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04642
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110400202
TX
01
8N9750
BLUE CROSS BLUE SHIELD
TX
01
PA04642
PA LICENSE
TX
Enumeration date
08/12/2006
Last updated
10/31/2019
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