Healthcare Provider Details

I. General information

NPI: 1124801915
Provider Name (Legal Business Name): EDUARD MICHEL CASTAGNET MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: EDDY MICHEL CASTAGNET MA

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E GRUBB DR
MESQUITE TX
75149-3402
US

IV. Provider business mailing address

4623 O CONNOR CT
IRVING TX
75062-3740
US

V. Phone/Fax

Practice location:
  • Phone: 972-928-4020
  • Fax:
Mailing address:
  • Phone: 336-324-8149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2837832
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: