Provider Demographics
NPI:1790579613
Name:CASART, JEFFREY L
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:CASART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S. TEXAS STREET
Mailing Address - Street 2:
Mailing Address - City:TIOGA
Mailing Address - State:TX
Mailing Address - Zip Code:76271
Mailing Address - Country:US
Mailing Address - Phone:940-902-3384
Mailing Address - Fax:
Practice Address - Street 1:100 S. TEXAS STREET
Practice Address - Street 2:
Practice Address - City:TIOGA
Practice Address - State:TX
Practice Address - Zip Code:76271
Practice Address - Country:US
Practice Address - Phone:866-656-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program