Provider Demographics
NPI:1003438615
Name:CASTRO GUERRA, MAYLEN
Entity Type:Individual
Prefix:
First Name:MAYLEN
Middle Name:
Last Name:CASTRO GUERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAYLEN
Other - Middle Name:
Other - Last Name:CASTRO GUERRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1888 BARKER CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-4578
Mailing Address - Country:US
Mailing Address - Phone:281-840-1455
Mailing Address - Fax:
Practice Address - Street 1:1888 BARKER CYPRESS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-4578
Practice Address - Country:US
Practice Address - Phone:281-840-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX988416163W00000X
TX1081260363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse