Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | TX |
NPI | 1134730831 |
---|---|
Provider Name | Mrs. Lori Casterlin |
First Address | Austin, TX 78723-1041 |
Second Address | Austin, TX 78723-1041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2020 |
Last Update Date | 14/08/2020 |