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Individual

CASEY D. BRANSTETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
5201 HARRY HINES BLVD, DEPT. OF ANESTHESIOLOGY, DALLAS, TX 75235-7708
(214) 590-8329
Mailing address
8612 GLENCREST LN, DALLAS, TX 75209-1605

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
651494
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163683901
TX
01
83613U
BLUE CROSS BLUE SHIELD
TX
01
8466UU
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/13/2005
Last updated
10/09/2009
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