Provider Demographics
NPI:1740693928
Name:CACERES, CASANDRA (FNP-C)
Entity type:Individual
Prefix:
First Name:CASANDRA
Middle Name:
Last Name:CACERES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 SOMERSET RD
Mailing Address - Street 2:#103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3884
Mailing Address - Country:US
Mailing Address - Phone:210-932-1323
Mailing Address - Fax:
Practice Address - Street 1:7127 SOMERSET RD
Practice Address - Street 2:#103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3884
Practice Address - Country:US
Practice Address - Phone:210-932-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily