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General NPI Number Information
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NPI Number | 1093675977
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Entity Type | Individual
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Provider Name | CASSIDY MOTTOLA CAA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 300 UNIVERSITY BLVD
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City | ROUND ROCK
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State | TX
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Zip | 78665-1032
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Country | US
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Telephone | 512-509-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 SHORE DISTRICT DR APT 1342
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City | AUSTIN
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State | TX
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Zip | 78741-1310
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Country | US
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Telephone | 603-370-2740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State |
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