Provider Demographics
NPI:1477519247
Name:WEBB, CASPER TREY III (DO)
Entity Type:Individual
Prefix:DR
First Name:CASPER
Middle Name:TREY
Last Name:WEBB
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 769
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-0769
Mailing Address - Country:US
Mailing Address - Phone:817-774-9322
Mailing Address - Fax:817-774-9323
Practice Address - Street 1:1910 W HENDERSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4144
Practice Address - Country:US
Practice Address - Phone:817-774-9322
Practice Address - Fax:817-774-9323
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208600000X208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096960203Medicaid
TX0084BQOtherBLUE CROSS
TX10030704OtherAMERICAID / AMERIGROUP
TX5507263002OtherCIGNA PPO/HMO
TX856134OtherCHIPS
TX503551OtherAETNA PPO/HMO
TXP00124619OtherMEDICARE RR
TX096960203Medicaid
TX503551OtherAETNA PPO/HMO