Individual
GRACIE ANN CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPA-C
Contact information
Practice address
6624 FANNIN ST, 2600, HOUSTON, TX 77030-2312
(713) 790-1818
(713) 790-7515
Mailing address
6624 FANNIN ST, 2600, HOUSTON, TX 77030-2312
(713) 790-1818
(713) 790-7515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OPA-C # 1063
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063
OPA-C ORTHOPAEDIC PHYSICIAN ASSISTANT-CERTIFIED
TX
Enumeration date
04/20/2009
Last updated
04/20/2009
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