Provider Demographics
NPI:1467167239
Name:CASTILLO ACOSTA, RUTH DILENIA
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:DILENIA
Last Name:CASTILLO ACOSTA
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 1:7809 S WHEELING AVE APT P
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8621
Mailing Address - Country:US
Mailing Address - Phone:956-540-1628
Mailing Address - Fax:
Practice Address - Street 1:7809 S WHEELING AVE APT 29P
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8621
Practice Address - Country:US
Practice Address - Phone:956-540-1628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist