Provider Demographics
NPI:1437652419
Name:CASTELLANOS, DEVIN L (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEVIN
Middle Name:L
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 TUMBLEWEED TRL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3157
Mailing Address - Country:US
Mailing Address - Phone:254-598-2445
Mailing Address - Fax:
Practice Address - Street 1:2006 S 1ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7450
Practice Address - Country:US
Practice Address - Phone:254-228-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135495363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily