Organization Active NPI

Diana Casanova, M.D., P.a.

  • Family Medicine Physician
  • Odessa, TX
National Provider Identifier
1407998735
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G8798 Issued in TX
Legal business name
DIANA CASANOVA, M.D., P.A.
Practice address
601 E 2ND St
Suite F
Odessa, TX 79761-5423
Phone
(432) 332-1273
Fax
(432) 367-8687
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Diana Casanova, M.D.
Title
Owner
Phone
(432) 332-1273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G8798 TX Primary

Addresses

Primary practice location

601 E 2ND St
Suite F
Odessa, TX 79761-5423

Mailing address

P O Box 13030
Odessa, TX 79768-3030
Phone (432) 332-1273

Other identifiers 1

IdentifierTypeStateIssuer
148739901MedicaidTX

National Provider Directory

National Provider Directory

Locations

4241 Tanglewood Ln
Ste 2
Odessa, TX 79762
Phone (432) 332-1273

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1407998735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 13030",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797683030",
            "telephone_number": "432-332-1273",
            "fax_number": "432-367-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 2ND ST",
            "address_2": "SUITE F",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615423",
            "telephone_number": "432-332-1273",
            "fax_number": "432-367-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA CASANOVA, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "CASANOVA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "432-332-1273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G8798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148739901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.