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General NPI Number Information
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NPI Number | 1124008990
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Entity Type | Individual
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Provider Name | JONATHAN CASSENS CPO, LPO
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2112 E VILLA MARIA RD
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City | BRYAN
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State | TX
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Zip | 77802-2542
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Country | US
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Telephone | 979-731-1985
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Fax | 979-776-8447
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Provider Business Mailing Address
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Address Line | 2112 E VILLA MARIA RD
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City | BRYAN
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State | TX
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Zip | 77802-2542
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Country | US
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Telephone | 979-731-1985
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Fax | 979-776-8447
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | 138
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | 138
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 102390
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License Number State | TX
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