Healthcare Provider Details

I. General information

NPI: 1134041395
Provider Name (Legal Business Name): MACALYN CASTRO-CARDENAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 S HIGLEY RD STE 103-477
GILBERT AZ
85296-1166
US

IV. Provider business mailing address

1307 BAYOU ST APT B
HOUSTON TX
77020-8212
US

V. Phone/Fax

Practice location:
  • Phone: 832-657-3659
  • Fax:
Mailing address:
  • Phone: 832-657-3659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number43500
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: