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NPI Code Detail

MEDICARE: JESSICA CASTRO

MEDICARE: JESSICA CASTRO
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
1164X00000XLicensed Vocational Nurse336387TX

General Provider Information

NPI Number : 1992235360
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CASTRO
Provider Business Mailing Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-472-4357
Fax Number : 512-703-1394
Provider Business Practice Location Address
First Line : 6600 E BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78741-7537
Country : US
Telephone Number : 512-440-4080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2017
Last Update Date : 06/18/2017

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Directions to “ JESSICA CASTRO ” Practice Location

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