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NPI Code Detail

MEDICARE: LISA MARIE CASTLE CCC-SLP

MEDICARE: LISA MARIE CASTLE CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1871115725
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE CASTLE CCC-SLP
Provider Business Mailing Address
First Line : 150 W SUNSET RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-2633
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 W SUNSET RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-2633
Country : US
Telephone Number : 254-833-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2020
Last Update Date : 05/14/2020

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Directions to “ LISA MARIE CASTLE CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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