Provider Demographics
NPI:1578927513
Name:GASTON, CAITLYN (OTR)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:GASTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 CABELAS DR
Mailing Address - Street 2:APT.715
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-6201
Mailing Address - Country:US
Mailing Address - Phone:210-912-9172
Mailing Address - Fax:
Practice Address - Street 1:12710 RESEARCH BLVD
Practice Address - Street 2:SUITE #395
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4379
Practice Address - Country:US
Practice Address - Phone:512-250-8706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117495225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist