Provider Demographics
NPI:1609889203
Name:CASS, ALLAN W (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:W
Last Name:CASS
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:PO BOX 847904
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7904
Mailing Address - Country:US
Mailing Address - Phone:325-649-5000
Mailing Address - Fax:325-649-3935
Practice Address - Street 1:1501 BURNET RD
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-8520
Practice Address - Country:US
Practice Address - Phone:325-649-5000
Practice Address - Fax:325-649-3935
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG09652085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122784506Medicaid
TX920006481OtherRAILROAD MEDICARE
TX122784506Medicaid
TX920006481OtherRAILROAD MEDICARE