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General NPI Number Information
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NPI Number | 1780333542
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Entity Type | Individual
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Provider Name | JOSSELYN ANDREA CASTILLO
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Gender | Female
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 215 CHURCHILL RD APT 1322
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City | RIVER OAKS
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State | TX
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Zip | 76114-3923
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Country | US
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Telephone | 806-206-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 WHITE SETTLEMENT RD APT 1322
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City | FORT WORTH
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State | TX
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Zip | 76114-3975
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Country | US
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Telephone | 806-206-0053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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