Provider Demographics
NPI:1417744814
Name:CASTILLO, CELINA DANIELLE
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:DANIELLE
Last Name:CASTILLO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 DAVIDSON ST UNIT 209
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5731
Mailing Address - Country:US
Mailing Address - Phone:817-723-4473
Mailing Address - Fax:
Practice Address - Street 1:5700 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9580
Practice Address - Country:US
Practice Address - Phone:469-515-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program