Healthcare Provider Details

I. General information

NPI: 1699580902
Provider Name (Legal Business Name): CASSIDY LEE SOLOMON OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S PRESTON RD
PROSPER TX
75078-3529
US

IV. Provider business mailing address

250 S PRESTON RD STE 20
PROSPER TX
75078-3529
US

V. Phone/Fax

Practice location:
  • Phone: 214-843-1023
  • Fax:
Mailing address:
  • Phone: 214-843-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number125187
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: