Provider Demographics
NPI:1235661851
Name:OLSON WILLIAMS, CASSANDRA R (DO)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:R
Last Name:OLSON WILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:R
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14530 NW MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1622
Mailing Address - Country:US
Mailing Address - Phone:210-450-6620
Mailing Address - Fax:210-450-6621
Practice Address - Street 1:14530 NW MILITARY HWY
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1622
Practice Address - Country:US
Practice Address - Phone:210-450-6620
Practice Address - Fax:210-450-6621
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT0588207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program