Provider Demographics
NPI:1225114853
Name:MORALES, CASSANDRA N (RPH)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:N
Last Name:MORALES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 WINDWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-2433
Mailing Address - Country:US
Mailing Address - Phone:210-657-0101
Mailing Address - Fax:210-657-7214
Practice Address - Street 1:8110 WINDWAY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-2433
Practice Address - Country:US
Practice Address - Phone:210-657-0101
Practice Address - Fax:210-657-7214
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14006124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist