Provider Demographics
NPI:1215938352
Name:CASSO, DANIEL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CASSO
Suffix:
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 1:2020 NASA PKWY
Mailing Address - Street 2:#260
Mailing Address - City:NASSAU BAY
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3683
Mailing Address - Country:US
Mailing Address - Phone:281-333-3500
Mailing Address - Fax:281-333-9455
Practice Address - Street 1:2020 NASA PKWY
Practice Address - Street 2:#260
Practice Address - City:NASSAU BAY
Practice Address - State:TX
Practice Address - Zip Code:77058-3683
Practice Address - Country:US
Practice Address - Phone:281-333-3500
Practice Address - Fax:281-333-9455
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH13522086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E35376Medicare UPIN
TXD17XMedicare ID - Type Unspecified