Provider Demographics
NPI:1780148783
Name:TAPIA, CASSANDRA JEANETTE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:JEANETTE
Last Name:TAPIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:JEANETTE
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1717 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RIVER OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76114-2110
Mailing Address - Country:US
Mailing Address - Phone:808-497-2005
Mailing Address - Fax:
Practice Address - Street 1:5801 OAKBEND TRL STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3916
Practice Address - Country:US
Practice Address - Phone:817-529-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily