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1952711947
KASSIE IDICULA
LUBBOCK, TX
NPI
1952711947
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Former Name
KASSIE NICOLE QUINTANA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA08972)
Enumeration Date
2014-04-30
Last Update Date
2014-10-13
Business Address
-- KASSIE IDICULA PA
2412 50TH ST
LUBBOCK, TX 79412-2504
Phone number: 806-744-7223
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Mailing Address
-- KASSIE IDICULA PA
2804 N LOOP 289
LUBBOCK, TX 79415-1410
Phone number: 806-744-7223
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