1982871091 NPI number — MADI E CASTILLO MS, SLP/ CCC-A

NPI Number: 1982871091
Health Care Provider/Practitioner: MADI E CASTILLO MS, SLP/ CCC-A

NPI Number : 1982871091 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982871091",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CASTILLO",
    "FirstName": "MADI",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, SLP/ CCC-A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "23210 WILLOW CANYON DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KATY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77494-3526",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "917-731-8140",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1011 S TEXAS 6 SUITE 311",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77077-7749",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "917-731-8140",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/08/2008",
    "LastUpdateDate": "03/13/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "231H00000X",
          "TaxonomyName": "Audiologist",
          "LicenseNumber": "AUD000109",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "111957",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}