Basic Information
| Provider Information | |||||||||
| NPI: | 1497113260 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHETSTONE | ||||||||
| FirstName: | CASSANDRA | ||||||||
| MiddleName: | SALINAS | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 614 MACO DR | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562967000 | ||||||||
| FaxNumber: | 9564409801 | ||||||||
| Practice Location | |||||||||
| Address1: | 614 MACO DR | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562967000 | ||||||||
| FaxNumber: | 9564409801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2016 | ||||||||
| LastUpdateDate: | 08/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 08/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2641 | OK | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA10413 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 3742595-02 | 05 | TX | MEDICAID | H08PT32401 | 01 | TX | BCBS | OTHER |