Provider Demographics
NPI:1992428254
Name:SAENZ CASTILLO, DIANA ISABEL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ISABEL
Last Name:SAENZ CASTILLO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 BODOVSKY ROAD
Mailing Address - Street 2:
Mailing Address - City:TIOGA
Mailing Address - State:TX
Mailing Address - Zip Code:76271
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 N LOY LAKE RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1701
Practice Address - Country:US
Practice Address - Phone:903-891-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist