Provider Demographics
NPI:1376173542
Name:CASTILLO, ASHLEY MAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MAE
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W GRAUWYLER RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-4345
Mailing Address - Country:US
Mailing Address - Phone:972-790-5747
Mailing Address - Fax:
Practice Address - Street 1:2201 W GRAUWYLER RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4345
Practice Address - Country:US
Practice Address - Phone:972-790-5747
Practice Address - Fax:972-790-5520
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538111835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist