Provider Demographics
NPI:1982983029
Name:CASTILLO, ANDREA MERCEDES (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MERCEDES
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:650 N SAM HOUSTON PKWY E
Mailing Address - Street 2:STE 105B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-5918
Mailing Address - Country:US
Mailing Address - Phone:281-272-1743
Mailing Address - Fax:281-272-1758
Practice Address - Street 1:650 N SAM HOUSTON PKWY E STE 105B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-5918
Practice Address - Country:US
Practice Address - Phone:281-272-1743
Practice Address - Fax:281-272-1758
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9249135363LF0000X
TXNP132868363LF0000X
FLRN9249135163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical