Individual
MR. JONATHAN CASSENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO, LPO
Contact information
Practice address
2112 E VILLA MARIA RD, BRYAN, TX 77802-2542
(979) 731-1985
(979) 776-8447
Mailing address
2112 E VILLA MARIA RD, BRYAN, TX 77802-2542
(979) 731-1985
(979) 776-8447
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
138
TX
224P00000X
Prosthetist
138
TX
225X00000X
Occupational Therapist
Primary
102390
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22102
SCOTT AND WHITE PROV ID
TX
01
—
515099
BCBS PROVIDER ID
TX
01
—
CPO01811
BOARD CERTIFICATION, ABC
—
Enumeration date
01/18/2006
Last updated
09/11/2025
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