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General NPI Number Information
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NPI Number | 1922681352
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Entity Type | Individual
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Provider Name | CASSANDRA IRIS MEDINA OTR
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Gender | Female
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 1901 E MONTE CRISTO RD
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City | EDINBURG
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State | TX
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Zip | 78542-0334
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Country | US
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Telephone | 956-583-4544
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Fax | 956-583-4545
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Provider Business Mailing Address
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Address Line | 1901 E MONTE CRISTO RD
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City | EDINBURG
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State | TX
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Zip | 78542-0334
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Country | US
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Telephone | 956-583-4544
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Fax | 956-583-4545
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 120377
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License Number State | TX
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