Provider Demographics
NPI:1447210521
Name:CASTILLO, EMILLE K (PT)
Entity Type:Individual
Prefix:
First Name:EMILLE
Middle Name:K
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 ARION PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2809
Mailing Address - Country:US
Mailing Address - Phone:210-366-2990
Mailing Address - Fax:210-491-8098
Practice Address - Street 1:1211 ARION PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2808
Practice Address - Country:US
Practice Address - Phone:210-366-2990
Practice Address - Fax:210-491-8098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1162531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN8T5129OtherBLUECROSS/BLUE SHIELD
TN8T5129OtherBLUECROSS/BLUE SHIELD