Provider Demographics
NPI:1487527511
Name:PREWITT, CASSI (LAT)
Entity type:Individual
Prefix:
First Name:CASSI
Middle Name:
Last Name:PREWITT
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 TOM SMITH RD
Mailing Address - Street 2:
Mailing Address - City:HARLETON
Mailing Address - State:TX
Mailing Address - Zip Code:75651-4939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:616 CAL YOUNG
Practice Address - Street 2:
Practice Address - City:HALLSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75650
Practice Address - Country:US
Practice Address - Phone:903-668-5990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT93082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer