Provider Demographics
NPI:1528604634
Name:CANTU, CASSANDRA NAVARRETE (NP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:NAVARRETE
Last Name:CANTU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-8119
Mailing Address - Country:US
Mailing Address - Phone:979-236-3932
Mailing Address - Fax:
Practice Address - Street 1:3725 E LEAGUE CITY PKWY STE 240
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7373
Practice Address - Country:US
Practice Address - Phone:281-223-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-24
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142886363LF0000X
TXAP142886363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily