Provider Demographics
NPI:1760852180
Name:GEE, CASSANDRA (PTA)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:GEE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 FM 613
Mailing Address - Street 2:
Mailing Address - City:TUSCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:79562-2302
Mailing Address - Country:US
Mailing Address - Phone:325-201-1710
Mailing Address - Fax:
Practice Address - Street 1:1018 FM 613
Practice Address - Street 2:
Practice Address - City:TUSCOLA
Practice Address - State:TX
Practice Address - Zip Code:79562-2302
Practice Address - Country:US
Practice Address - Phone:325-201-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013681225200000X
TX2105621225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant