Provider Demographics
NPI:1457114969
Name:CASTRO-OLIVO, SARA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MARIA
Last Name:CASTRO-OLIVO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14388 ZION GATE XING
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-2516
Mailing Address - Country:US
Mailing Address - Phone:541-729-0082
Mailing Address - Fax:
Practice Address - Street 1:14388 ZION GATE XING
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-2516
Practice Address - Country:US
Practice Address - Phone:541-729-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71209103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool