Provider Demographics
NPI:1225402084
Name:CASTRO, DEODE L (LCDC-I)
Entity Type:Individual
Prefix:MR
First Name:DEODE
Middle Name:L
Last Name:CASTRO
Suffix:
Gender:M
Credentials:LCDC-I
Other - Prefix:MR
Other - First Name:DEODE
Other - Middle Name:L
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6602 BLUEBOTTLE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4498
Mailing Address - Country:US
Mailing Address - Phone:541-633-5112
Mailing Address - Fax:
Practice Address - Street 1:6201 BONHOMME RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4365
Practice Address - Country:US
Practice Address - Phone:832-862-7997
Practice Address - Fax:713-583-0722
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator