Individual
KENDALL CASTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,LD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-1990
(682) 885-1985
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT83822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355128501
—
TX
Enumeration date
12/21/2015
Last updated
10/24/2018
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