Provider Demographics
NPI:1538767488
Name:POCASANGRE, DANA ROSE
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:ROSE
Last Name:POCASANGRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LEFFINGWELL LN
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-2245
Mailing Address - Country:US
Mailing Address - Phone:737-283-2825
Mailing Address - Fax:833-801-0289
Practice Address - Street 1:101 LEFFINGWELL LN
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-2245
Practice Address - Country:US
Practice Address - Phone:737-283-2825
Practice Address - Fax:833-801-0289
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF09201365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily