Provider Demographics
NPI:1699002261
Name:CASTILLO, JOHANNA A (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:A
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 SWEETWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3125
Mailing Address - Country:US
Mailing Address - Phone:281-980-6304
Mailing Address - Fax:281-980-9132
Practice Address - Street 1:4711 SWEETWATER BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3125
Practice Address - Country:US
Practice Address - Phone:281-980-6304
Practice Address - Fax:281-980-9132
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist