Provider Demographics
NPI:1144435264
Name:CASTLE, MARGARET ANN (PTA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:CASTLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38134 E LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4165
Mailing Address - Country:US
Mailing Address - Phone:225-290-3246
Mailing Address - Fax:
Practice Address - Street 1:402 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3108
Practice Address - Country:US
Practice Address - Phone:936-632-2107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA4952225200000X
TX2078950225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant