Provider Demographics
NPI:1871198374
Name:CASAS, OCTAVIO (DC)
Entity Type:Individual
Prefix:DR
First Name:OCTAVIO
Middle Name:
Last Name:CASAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9104 JACK PAYNE DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-1695
Mailing Address - Country:US
Mailing Address - Phone:806-337-0811
Mailing Address - Fax:
Practice Address - Street 1:3505 OLSEN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3096
Practice Address - Country:US
Practice Address - Phone:806-337-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor