Provider Demographics
NPI:1558353169
Name:MCCASKILL, DAVID M (FNP-C, ACNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:MCCASKILL
Suffix:
Gender:M
Credentials:FNP-C, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6400
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-606-6137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX568154363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167104203Medicaid
TX167104204Medicaid
TX752616977180OtherTRICARE
TX8077NROtherBCBS
TX833N79OtherBCBS
TX167104201Medicaid
TX167104205Medicaid
TX75-0818167-022OtherTRICARE
TX8N3752OtherBCBS OF TEXAS
TXP01549686OtherRAIL ROAD
TX167104202Medicaid
TX75-2616977-007OtherTRICARE
TX75-0818167-048OtherTRICARE
TX75-2616977-001OtherTRICARE
TXP01487045OtherRAIL ROAD
TX75-2616977-002OtherTRICARE
TX75-2616977-028OtherTRICARE
TX75-2616977-042OtherTRICARE
TX8968NPOtherBCBS
TX8968NPOtherBCBS
TX75-2616977-042OtherTRICARE
TX75-0818167-022OtherTRICARE
TX167104202Medicaid
TXTXB118196Medicare PIN
TX379721YS6PMedicare PIN
P36180Medicare UPIN
TX167104201Medicaid