Provider Demographics
NPI:1386399418
Name:CASCO VISION PLLC
Entity type:Organization
Organization Name:CASCO VISION PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWENER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANTZ
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:620-271-1377
Mailing Address - Street 1:12331 N GESSNER RD APT 1235
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-7676
Mailing Address - Country:US
Mailing Address - Phone:620-271-1377
Mailing Address - Fax:
Practice Address - Street 1:4846 FM 1463 SUITE 400
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7706
Practice Address - Country:US
Practice Address - Phone:620-271-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty