Healthcare Provider Details

I. General information

NPI: 1114906807
Provider Name (Legal Business Name): TIA CATHERINE CASTILLE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W PINHOOK RD SUITE 201
LAFAYETTE LA
70503-2460
US

IV. Provider business mailing address

1000 W PINHOOK RD SUITE 201
LAFAYETTE LA
70503-2460
US

V. Phone/Fax

Practice location:
  • Phone: 337-237-0650
  • Fax: 337-237-1086
Mailing address:
  • Phone: 337-237-0650
  • Fax: 337-237-1086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: