Provider Demographics
NPI:1316950256
Name:MCCASLAND, RICHARD SHANE (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SHANE
Last Name:MCCASLAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CLUBVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6304
Mailing Address - Country:US
Mailing Address - Phone:806-894-6830
Mailing Address - Fax:806-897-1720
Practice Address - Street 1:124 CLUBVIEW DR
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-6304
Practice Address - Country:US
Practice Address - Phone:806-894-6830
Practice Address - Fax:806-897-1720
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1522394OtherUNITED CONCORDIA
TXB18668OtherTEXAS CHIP DENTAL