Provider Demographics
NPI:1548947583
Name:TAYLOR, CASSANDRA BARNES
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:BARNES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:HUNGERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77448-0414
Mailing Address - Country:US
Mailing Address - Phone:281-779-0070
Mailing Address - Fax:
Practice Address - Street 1:1601 BRAVO ST
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-5808
Practice Address - Country:US
Practice Address - Phone:281-779-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA954015376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide