Provider Demographics
NPI:1427539964
Name:SAVAGE, CASIE TENILLE
Entity Type:Individual
Prefix:
First Name:CASIE
Middle Name:TENILLE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:587 VZ CR 1523
Mailing Address - Street 2:
Mailing Address - City:GRAND SALINE
Mailing Address - State:TX
Mailing Address - Zip Code:75140
Mailing Address - Country:US
Mailing Address - Phone:972-935-3928
Mailing Address - Fax:
Practice Address - Street 1:1440 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:WILLS POINT
Practice Address - State:TX
Practice Address - Zip Code:75169-3135
Practice Address - Country:US
Practice Address - Phone:903-873-4404
Practice Address - Fax:903-873-5400
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2039220225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant