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General NPI Number Information
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NPI Number | 1902757495
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Entity Type | Individual
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Provider Name | KASSANDRA LARISSA AGUNDIZ NP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 4709 W PARKER RD STE 420
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City | PLANO
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State | TX
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Zip | 75093-3369
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Country | US
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Telephone | 469-732-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 108 WILLOW OAK DR
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City | KRUGERVILLE
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State | TX
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Zip | 76227-2649
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Country | US
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Telephone | 469-732-7171
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1010989
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License Number State | TX
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