Provider Demographics
NPI:1780625806
Name:MCCASKILL, BERNIE LOUIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:BERNIE
Middle Name:LOUIS
Last Name:MCCASKILL
Suffix:JR
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 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-691-7077
Mailing Address - Fax:214-692-8421
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-691-7077
Practice Address - Fax:214-692-8421
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9799207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000J85N4Medicaid
TXB24706Medicare UPIN
TX00J85NMedicare PIN