Provider Demographics
NPI:1275686677
Name:JAMES, KASSIDY NICHELE (PA)
Entity Type:Individual
Prefix:
First Name:KASSIDY
Middle Name:NICHELE
Last Name:JAMES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KASSIDY
Other - Middle Name:NICHELE
Other - Last Name:HELMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-3597
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BOULEVARD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-645-3597
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05087363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant