Provider Demographics
NPI:1467480038
Name:CASAS, CARLOS N (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:N
Last Name:CASAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 S ZAPATA HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6174
Mailing Address - Country:US
Mailing Address - Phone:956-726-2429
Mailing Address - Fax:956-726-5364
Practice Address - Street 1:1802 S ZAPATA HWY STE 1
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-6174
Practice Address - Country:US
Practice Address - Phone:956-726-2429
Practice Address - Fax:956-726-5364
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101331001Medicaid
TX110171955OtherPALMETTO GBA
TXG36460Medicare UPIN