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General NPI Number Information
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NPI Number | 1154248227
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Entity Type | Organization
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Legal Business Name | EDSM
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 1651 JUSTIN RD
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City | FLOWER MOUND
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State | TX
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Zip | 75028-4323
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Country | US
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Telephone | 972-982-7411
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Fax | 972-982-7610
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Provider Business Mailing Address
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Address Line | 1651 JUSTIN RD
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City | FLOWER MOUND
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State | TX
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Zip | 75028-4323
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Country | US
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Telephone | 972-982-7411
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Fax | 972-982-7610
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DIANA PATRICIA CASTRO
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Credential | MD
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Telephone | 917-837-2351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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