Provider Demographics
NPI:1790808541
Name:CASTILLO, ANNABEL CORTEZ (OTR, CHT)
Entity type:Individual
Prefix:
First Name:ANNABEL
Middle Name:CORTEZ
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-1917
Mailing Address - Country:US
Mailing Address - Phone:956-283-9442
Mailing Address - Fax:956-283-9456
Practice Address - Street 1:2504 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3348
Practice Address - Country:US
Practice Address - Phone:956-519-2700
Practice Address - Fax:956-519-3935
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108003225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159487102Medicaid