Healthcare Provider Details

I. General information

NPI: 1396506085
Provider Name (Legal Business Name): CASSIA ANN JOSEPH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8915 HARRY HINES BLVD
DALLAS TX
75235-1717
US

IV. Provider business mailing address

505 LANCASHIRE DR
FLOWER MOUND TX
75028-7143
US

V. Phone/Fax

Practice location:
  • Phone: 214-351-3490
  • Fax:
Mailing address:
  • Phone: 168-255-4445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1106509
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: