Provider Demographics
NPI:1841661444
Name:CASTELLANO, MICHELLE ANN (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANN
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11810 S US HIGHWAY 181
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-4278
Mailing Address - Country:US
Mailing Address - Phone:210-818-0098
Mailing Address - Fax:
Practice Address - Street 1:790 FM 3009 STE E
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2039
Practice Address - Country:US
Practice Address - Phone:210-659-4333
Practice Address - Fax:210-659-0809
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1247625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist