Individual
JESSICA MAYRA CASTORENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
4502 MEDICAL DR, DEPT OF PEDIATRIC CRITICAL CARE, SAN ANTONIO, TX 78229-4402
(210) 257-1400
(210) 257-1428
Mailing address
7703 FLOYD CURL, DEPT OF PEDIATRIC CRITICAL CARE, SAN ANTONIO, TX 78229-3901
(210) 257-1400
(210) 257-1428
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
690854
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200184405
—
TX
01
—
200184406
CSHCN
TX
Enumeration date
10/15/2008
Last updated
11/05/2015
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