Individual provider Active NPI

Cassandra Smith, PAC

  • Physician Assistant
  • Shenandoah, TX
National Provider Identifier
1871064352
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17102 Issued in TX
Practice address
111 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3003
Phone
(713) 714-1399
NPI assigned
Dec 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17102 TX Primary

Addresses

Primary practice location

111 Vision Park Blvd Ste 100
Shenandoah, TX 77384-3003

Mailing address

14296 Aspen Valley Dr
Conroe, TX 77384-1518
Phone (724) 953-2901

Other names 1

  • Cassandra Barker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200219000357 NJ Practitioner - Physician Assistant 8527495241 Reassigns benefits to 1 organization
I20250912000642 TX Practitioner - Physician Assistant 8527495241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 Vision Park Blvd
Suite 100
Shenandoah, TX 77384-3002

14296 Aspen Valley Dr
Conroe, TX 77384-1518

2501 W Burbank Blvd
Suite 200
Burbank, CA 91505-2347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Procura Pain and Spine, PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

111 Vision Park Blvd
Ste 100
Shenandoah, TX 77384
Phone (281) 362-0006

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1871064352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14296 ASPEN VALLEY DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773841518",
            "telephone_number": "724-953-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 VISION PARK BLVD STE 100",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843003",
            "telephone_number": "713-714-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CASSANDRA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "BARKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.