Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | M5087 | TX |
NPI | 1013067909 |
---|---|
Provider Name | Theresa O Castillo |
First Address | Houston, TX 77070-4301 |
Second Address | Houston, TX 77070-4301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 02/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189081601 | (05) | TX |