Healthcare Provider Details

I. General information

NPI: 1568533818
Provider Name (Legal Business Name): CHRISTINE L CASTILLO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE L FRENCH PH.D.

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 11/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 HARRY HINES BLVD CHILDREN'S MEDICAL CENTER DALLAS, NEUROPSYCHOLOGY
DALLAS TX
75235-5259
US

IV. Provider business mailing address

600H EDEN ROAD
LANCASTER PA
17601
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-5872
  • Fax: 214-456-2220
Mailing address:
  • Phone: 717-397-1400
  • Fax: 717-509-4066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number33096
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: