Healthcare Provider Details

I. General information

NPI: 1750199451
Provider Name (Legal Business Name): KASSANDRA RENEE ALMARAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MCKENZIE RD
ORANGE GROVE TX
78372-2030
US

IV. Provider business mailing address

110 MCKENZIE RD
ORANGE GROVE TX
78372-2030
US

V. Phone/Fax

Practice location:
  • Phone: 361-661-9911
  • Fax:
Mailing address:
  • Phone: 361-661-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: