Provider Demographics
NPI:1558359729
Name:CASIAS, LUKE
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:CASIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 SUTTLE ST
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8276
Mailing Address - Country:US
Mailing Address - Phone:970-335-2232
Mailing Address - Fax:970-335-2438
Practice Address - Street 1:1970 E 3RD AVE STE 1
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5049
Practice Address - Country:US
Practice Address - Phone:970-335-2288
Practice Address - Fax:970-335-2280
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42099207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11288256OtherNEW MEXICO MEDICAID
CO840706945162OtherROCKY MOUNTAIN HEALTH PLA
P00231961OtherTRAVELERS MEDICARE
201047689OtherPRESBYTERIAN HEALTH PLAN
CO11104341Medicaid
COCA669196OtherANTHEM BCBS
P00231961OtherTRAVELERS MEDICARE