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General NPI Number Information
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NPI Number | 1487137519
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Entity Type | Individual
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Provider Name | CASSANDRA LEE SHRIVER
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Gender | Female
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 2735 AIRLINE RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-3306
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Country | US
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Telephone | 361-992-0816
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 N.P.I.D. APT# 17107
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City | CORPUS CHRISTI
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State | TX
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Zip | 78408
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Country | US
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Telephone | 361-946-0470
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2131817
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License Number State | TX
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