Provider Demographics
NPI:1043800352
Name:CASTILLO, DEBORAH ANN (DEBORAH CASTILLO LMT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:DEBORAH CASTILLO LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5126 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4752
Mailing Address - Country:US
Mailing Address - Phone:361-741-0838
Mailing Address - Fax:
Practice Address - Street 1:5126 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4752
Practice Address - Country:US
Practice Address - Phone:361-741-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129930225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist