Provider Demographics
NPI:1144377169
Name:CASAS, PEDRO ANTONIO (PHD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:ANTONIO
Last Name:CASAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 MUSTANG TRL
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2475
Mailing Address - Country:US
Mailing Address - Phone:254-535-9950
Mailing Address - Fax:
Practice Address - Street 1:RESILIENCE AND RESTORATION CENTER
Practice Address - Street 2:BUILDING 36003
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-553-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19668103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19668OtherPSYCHOLOGIST