Provider Demographics
NPI:1023563798
Name:POLANSKI, CASSANDRA LYNNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNNE
Last Name:POLANSKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 RUNNERS RDG
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3704
Mailing Address - Country:US
Mailing Address - Phone:254-338-3579
Mailing Address - Fax:
Practice Address - Street 1:608 RUNNERS RDG
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3704
Practice Address - Country:US
Practice Address - Phone:254-338-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1281889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist