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NPI Code Detail

MEDICARE: CHANTELLE INEZ CASTANEDA OTR

MEDICARE: CHANTELLE INEZ CASTANEDA OTR
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
1225X00000XOccupational Therapist111939TX

General Provider Information

NPI Number : 1235260787
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTELLE INEZ CASTANEDA OTR
Provider Business Mailing Address
First Line : 13400 EMERALD TIDE WAY
Second Line :
City : HORIZON CITY
State : TX
Zip : 79928-6463
Country : US
Telephone Number : 915-204-5137
Fax Number : 915-771-8046
Provider Business Practice Location Address
First Line : 6028 SURETY DR
Second Line :
City : EL PASO
State : TX
Zip : 79905-2018
Country : US
Telephone Number : 915-771-8523
Fax Number : 915-771-8046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/19/2013

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Directions to “ CHANTELLE INEZ CASTANEDA OTR” Practice Location

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