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Individual

CASEY D TABER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
150 E SONTERRA BLVD STE 300, SAN ANTONIO, TX 78258-4184
(210) 804-5460
(210) 804-5461
Mailing address
400 CONCORD PLAZA DR, SUITE 300, SAN ANTONIO, TX 78216-6905
(210) 804-5460
(210) 804-5461

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M2141
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00594R
GROUP PTAN
05
145160102
TX
01
1972711463
NPI
Enumeration date
05/18/2007
Last updated
07/21/2022
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