Provider Demographics
NPI:1568642148
Name:CASTRO, GERALDINE BRENDA (OTR/L)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:BRENDA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:GERALDINE
Other - Middle Name:BRENDA
Other - Last Name:NAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:135 GALWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-2815
Mailing Address - Country:US
Mailing Address - Phone:210-835-4537
Mailing Address - Fax:
Practice Address - Street 1:135 GALWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-2815
Practice Address - Country:US
Practice Address - Phone:210-835-4537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100313225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist