Provider Demographics
NPI:1093294852
Name:SERMENO CASTILLO, KARLA JUDITH
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:JUDITH
Last Name:SERMENO CASTILLO
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 1:25407 MESA VW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4825
Mailing Address - Country:US
Mailing Address - Phone:323-632-3421
Mailing Address - Fax:
Practice Address - Street 1:5841 NW LOOP 410 STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-2526
Practice Address - Country:US
Practice Address - Phone:210-521-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-11
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344811223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty