Individual
KIM A CASTLEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5900 COIT RD, PLANO, TX 75023-5959
(972) 985-1412
(972) 964-5758
Mailing address
5900 COIT RD, PLANO, TX 75023-5959
(972) 985-1412
(972) 964-5758
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3161TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100613202
—
TX
Enumeration date
07/25/2006
Last updated
02/18/2013
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