Provider Demographics
NPI:1235325705
Name:CASTILLO, DAHLIA CAVAZOS (MS, OTR)
Entity Type:Individual
Prefix:
First Name:DAHLIA
Middle Name:CAVAZOS
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6960 BRUCE BISSONETTE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-8516
Mailing Address - Country:US
Mailing Address - Phone:915-373-4179
Mailing Address - Fax:
Practice Address - Street 1:6960 BRUCE BISSONETTE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-8516
Practice Address - Country:US
Practice Address - Phone:915-373-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103925225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist