Provider Demographics
NPI:1063488823
Name:CASON, SCOTT (CRNA)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:CASON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:600 S TYLER ST STE 2100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6248
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX532900367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163393508Medicaid
TX83844UOtherBCBS PROV #
TX163393501Medicaid
TX8320UGOtherBCBS
TXP00081749OtherRAILROAD
040647OtherRE-CERT #
OK200019830AMedicaid
TX8320UGOtherBCBS
040647OtherRE-CERT #
TX163393505Medicaid
TX8B2561Medicare PIN
TXP00081749OtherRAILROAD