Provider Demographics
NPI:1801221585
Name:STRANDER, CASEY (CNIM)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:STRANDER
Suffix:
Gender:M
Credentials:CNIM
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 1577
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-1577
Mailing Address - Country:US
Mailing Address - Phone:504-577-0510
Mailing Address - Fax:888-344-2947
Practice Address - Street 1:33518 HALEY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-5110
Practice Address - Country:US
Practice Address - Phone:888-344-2947
Practice Address - Fax:888-344-2947
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2678246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic