Provider Demographics
NPI:1013951110
Name:CASAS, JORGE (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:CASAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:
Other - Last Name:CASAS-GANEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12222 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3720
Mailing Address - Country:US
Mailing Address - Phone:214-615-1944
Mailing Address - Fax:214-615-1949
Practice Address - Street 1:12222 N CENTRAL EXPY
Practice Address - Street 2:SUITE 210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3720
Practice Address - Country:US
Practice Address - Phone:214-615-1949
Practice Address - Fax:214-615-1949
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2174207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149969103Medicaid
8W5930OtherBCBS
8F4097Medicare UPIN