Provider Demographics
NPI:1518274208
Name:CASTANEDA, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CASTANEDA
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 1:108 N JACKSON RD STE 22
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-3694
Mailing Address - Country:US
Mailing Address - Phone:956-383-3200
Mailing Address - Fax:956-383-3204
Practice Address - Street 1:108 N JACKSON RD STE 22
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-3694
Practice Address - Country:US
Practice Address - Phone:956-383-3200
Practice Address - Fax:956-383-3204
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies