Provider Demographics
NPI:1447741764
Name:CASTEEL, GLENDA JOYCE
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:JOYCE
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 LOVE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-4323
Mailing Address - Country:US
Mailing Address - Phone:903-284-3006
Mailing Address - Fax:
Practice Address - Street 1:601 LOVE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-4323
Practice Address - Country:US
Practice Address - Phone:903-284-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant