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General NPI Number Information
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NPI Number | 1477360485
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Entity Type | Individual
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Provider Name | CASSANDRA JEWELL VERZWYVELT RPA
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Gender | Female
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 1820 PRESTON PARK BLVD STE 2400
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City | PLANO
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State | TX
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Zip | 75093-3716
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Country | US
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Telephone | 972-599-9327
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Fax | 972-370-5963
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Provider Business Mailing Address
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Address Line | 1820 PRESTON PARK BLVD STE 2400
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City | PLANO
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State | TX
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Zip | 75093-3716
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Country | US
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Telephone | 972-599-9327
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Fax | 972-370-5963
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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 | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | 24FL1216
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License Number State |
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Taxonomy #2
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 531193
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License Number State |
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Taxonomy #4
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | GMR02004190
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License Number State | TX
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