MEDICARE: CASSANDRA ORALIA CABALLERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	215765	TX

General Provider Information

NPI Number	:	1639721848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA ORALIA CABALLERO

Provider Business Mailing Address
First Line	:	2407 LARGO ST
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-9113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5907 NINE MILE LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2590
Country	:	US
Telephone Number	:	914-564-6550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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Directions to “ CASSANDRA ORALIA CABALLERO ” Practice Location

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