Active NPI
Miranda Leigh Castillo, RDN, CDE
- Registered Dietitian
- Selma, TX
National Provider Identifier
1659889152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT84930
- Practice address
- 16111 Ike LN
Selma, TX 78154-1154 - Phone
- (361) 813-8810
- NPI assigned
- Jan 18, 2018
- Last updated
- Mar 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT84930 | TX | Primary |
Addresses
Primary practice location
16111 Ike LN
Selma, TX 78154-1154
Mailing address
16111 Ike LN
Selma, TX 78154-1154
Phone (361) 813-8810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT84930 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1659889152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16111 IKE LN",
"city": "SELMA",
"state": "TX",
"postal_code": "781541154",
"telephone_number": "361-813-8810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16111 IKE LN",
"city": "SELMA",
"state": "TX",
"postal_code": "781541154",
"telephone_number": "361-813-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "MIRANDA",
"middle_name": "LEIGH",
"credential": "RDN, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-18",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT84930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selma, TX
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- Thomas Lee Brewer
- Alisa A. Brzek, LPC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.