Provider Demographics
NPI:1710588355
Name:CASTRO, LIZETTE M (FNP)
Entity Type:Individual
Prefix:
First Name:LIZETTE
Middle Name:M
Last Name:CASTRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5749 SAN FELIPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3101
Mailing Address - Country:US
Mailing Address - Phone:281-783-8162
Mailing Address - Fax:713-439-7995
Practice Address - Street 1:5749 SAN FELIPE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3101
Practice Address - Country:US
Practice Address - Phone:281-783-8162
Practice Address - Fax:713-439-7995
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019451363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner