Individual
STEPHANIE CASELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9835 N LAKE CREEK PKWY, AUSTIN, TX 78717-6210
(737) 229-3502
(737) 229-3532
Mailing address
9835 N LAKE CREEK PKWY, AUSTIN, TX 78717-6210
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
U9864
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113954700
—
FL
Enumeration date
03/29/2018
Last updated
05/25/2024
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