Provider Demographics
NPI:1912599275
Name:CASTELLAW, THMERICA MICHELLE
Entity Type:Individual
Prefix:MS
First Name:THMERICA
Middle Name:MICHELLE
Last Name:CASTELLAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:GROVES
Mailing Address - State:TX
Mailing Address - Zip Code:77619-6327
Mailing Address - Country:US
Mailing Address - Phone:409-527-0451
Mailing Address - Fax:
Practice Address - Street 1:7230 LEONARD ST
Practice Address - Street 2:
Practice Address - City:GROVES
Practice Address - State:TX
Practice Address - Zip Code:77619-6327
Practice Address - Country:US
Practice Address - Phone:409-527-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician