Healthcare Provider Details

I. General information

NPI: 1457815557
Provider Name (Legal Business Name): APRIL CHRISTINE CAUDILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 YAUPON CT
LAKE JACKSON TX
77566-4423
US

IV. Provider business mailing address

56 YAUPON CT
LAKE JACKSON TX
77566-4423
US

V. Phone/Fax

Practice location:
  • Phone: 979-285-5155
  • Fax:
Mailing address:
  • Phone: 979-285-5155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: