Provider Demographics
NPI:1467097154
Name:ACUNA, KASSANDRA
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:
Last Name:ACUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KASSANDRA
Other - Middle Name:
Other - Last Name:FERREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1806 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:TX
Mailing Address - Zip Code:75459-2919
Mailing Address - Country:US
Mailing Address - Phone:832-434-7905
Mailing Address - Fax:
Practice Address - Street 1:2305 N ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3434
Practice Address - Country:US
Practice Address - Phone:713-714-7211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-17
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty