Provider Demographics
NPI:1689438103
Name:CASAS, BRYAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:CASAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E SLAUGHTER LN APT 237
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-2205
Mailing Address - Country:US
Mailing Address - Phone:702-506-1486
Mailing Address - Fax:
Practice Address - Street 1:333 E SLAUGHTER LN APT 237
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-2205
Practice Address - Country:US
Practice Address - Phone:702-506-1486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1373775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist