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General NPI Number Information
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NPI Number | 1114097748
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Entity Type | Individual
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Provider Name | JOHN W CASSIDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1 RIVERWAY SUITE 600
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City | HOUSTON
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State | TX
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Zip | 77056-1920
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Country | US
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Telephone | 713-355-6111
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Fax | 713-355-6822
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Provider Business Mailing Address
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Address Line | 1 RIVERWAY STE 700
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City | HOUSTON
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State | TX
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Zip | 77056-1988
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Country | US
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Telephone | 713-355-6111
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Fax | 713-355-6822
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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 | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | H3450
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | H3450
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0005X
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Taxonomy Name | Neurodevelopmental Disabilities Physician
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License Number | H3450
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H3450
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2084P0301X
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Taxonomy Name | Brain Injury Medicine (Psychiatry & Neurology) Physician
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License Number | H3450
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License Number State | TX
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