Individual
CASEY DAWN OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
400 S LOOP 336 W, CONROE, TX 77304-3302
(936) 539-4500
(936) 539-4050
Mailing address
100 DETERING ST APT 2134, HOUSTON, TX 77007-1384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9419T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433634901
—
TX
Enumeration date
06/28/2018
Last updated
07/19/2022
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