Provider Demographics
NPI:1982402269
Name:HERRERA, CASSANDRA NICOLE (LMT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:NICOLE
Last Name:HERRERA
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 591596
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0129
Mailing Address - Country:US
Mailing Address - Phone:915-540-5721
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 591596
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-0129
Practice Address - Country:US
Practice Address - Phone:915-540-5721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT126877225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty