Provider Demographics
NPI:1760887541
Name:CASTILLO, MARIBEL (APRN, CPNP)
Entity type:Individual
Prefix:MS
First Name:MARIBEL
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:4102 24TH ST STE 201
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1801
Practice Address - Country:US
Practice Address - Phone:806-795-1801
Practice Address - Fax:806-795-1373
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126706363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX382103801OtherFIRSTCARE
TX394088YKT8OtherMEDICARE
TX8152NWOtherBCBS
TX343975404Medicaid
NM16905016Medicaid