Provider Demographics
NPI:1992098388
Name:VANDE CASTLE, ALISON BROOKE (DPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:BROOKE
Last Name:VANDE CASTLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15825 PUNTA ESPADA LOOP
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6624
Mailing Address - Country:US
Mailing Address - Phone:708-308-4350
Mailing Address - Fax:
Practice Address - Street 1:5718 SPOHN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4235
Practice Address - Country:US
Practice Address - Phone:361-906-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1254188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist