Provider Demographics
NPI:1023120987
Name:NAVARRETE, CASSANDRA SANFORD (PA)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:SANFORD
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 BENS BRANCH DR APT 1401
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3746
Mailing Address - Country:US
Mailing Address - Phone:832-966-3376
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:7821 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-2205
Practice Address - Country:US
Practice Address - Phone:832-966-3376
Practice Address - Fax:855-227-3506
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02333363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00470493Medicare PIN
57460P943Medicare PIN
P00470493Medicare PIN