Provider Demographics
NPI:1396133385
Name:MEYER, CASEY JAMES (MS, ATC, LAT, CSCS)
Entity type:Individual
Prefix:MR
First Name:CASEY
Middle Name:JAMES
Last Name:MEYER
Suffix:
Gender:M
Credentials:MS, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 TAMU
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77843-1228
Mailing Address - Country:US
Mailing Address - Phone:979-862-1162
Mailing Address - Fax:
Practice Address - Street 1:1228 TAMU
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-1228
Practice Address - Country:US
Practice Address - Phone:979-862-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer