Provider Demographics
NPI:1821253063
Name:ZEPEDA, ISABEL CASTILLO (MA CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:ISABEL
Middle Name:CASTILLO
Last Name:ZEPEDA
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 E BEVERLY MAE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4937
Mailing Address - Country:US
Mailing Address - Phone:210-219-8833
Mailing Address - Fax:
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-358-4583
Practice Address - Fax:210-358-2654
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14376235Z00000X
TX80416237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist