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NPI Code Detail

MEDICARE: JELINA MARIE VILLADELREY CASTILLO

MEDICARE: JELINA MARIE VILLADELREY CASTILLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianU2451TX

General Provider Information

NPI Number : 1073141818
Entity Type Code : Individual
Provider Name (Legal Business Name) : JELINA MARIE VILLADELREY CASTILLO
Provider Business Mailing Address
First Line : 6701 FANNIN ST STE 1710
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2616
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6621 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2358
Country : US
Telephone Number : 832-824-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2020
Last Update Date : 06/15/2026

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Directions to “ JELINA MARIE VILLADELREY CASTILLO ” Practice Location

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