Provider Demographics
NPI:1194157248
Name:BENEDICK, CASSANDRA NOEL (OD)
Entity type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:NOEL
Last Name:BENEDICK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:100 COUNTRY VIEW DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-2055
Mailing Address - Country:US
Mailing Address - Phone:817-491-2018
Mailing Address - Fax:817-430-2018
Practice Address - Street 1:100 COUNTRY VIEW DR STE 100
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-2055
Practice Address - Country:US
Practice Address - Phone:817-491-2018
Practice Address - Fax:817-430-2018
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8244T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist