Provider Demographics
NPI:1871763219
Name:CASAVANTES, RENE OSCAR (DMD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:OSCAR
Last Name:CASAVANTES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E SCHUSTER AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4360
Mailing Address - Country:US
Mailing Address - Phone:915-544-9500
Mailing Address - Fax:
Practice Address - Street 1:615 E SCHUSTER AVE STE 4
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4360
Practice Address - Country:US
Practice Address - Phone:915-544-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics