Organization
DIANA CASANOVA, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA CASANOVA M.D. (OWNER)
(432) 332-1273
Entity
Organization
Contact information
Practice address
601 E 2ND ST, SUITE F, ODESSA, TX 79761-5423
(432) 332-1273
(432) 367-8687
Mailing address
P O BOX 13030, ODESSA, TX 79768-3030
(432) 332-1273
(432) 367-8687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G8798
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148739901
—
TX
Enumeration date
02/13/2007
Last updated
09/06/2012
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