Provider Demographics
NPI:1154398022
Name:CASANOVA, ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:CASANOVA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCE CTR
Mailing Address - Street 2:3601 4TH STREET STOP 8340
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8340
Mailing Address - Country:US
Mailing Address - Phone:806-743-2482
Mailing Address - Fax:806-743-3200
Practice Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCE CTR
Practice Address - Street 2:3601 4TH STREET STOP 8340
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8340
Practice Address - Country:US
Practice Address - Phone:806-743-2482
Practice Address - Fax:806-743-3200
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2011-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG4900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122875105Medicaid
TX122875105Medicaid
TX8C2134Medicare ID - Type Unspecified