Provider Demographics
NPI:1104959840
Name:CASTELLO, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:CASTELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 E TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-3024
Mailing Address - Country:US
Mailing Address - Phone:979-968-3784
Mailing Address - Fax:979-968-6613
Practice Address - Street 1:932 E TRAVIS ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-3024
Practice Address - Country:US
Practice Address - Phone:979-968-3784
Practice Address - Fax:979-968-6613
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1775237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist