Active NPI
Jesus Alberto Castillo Polanco, FNC
- Nutrition Education Nutritionist
- Katy, TX
National Provider Identifier
1780288142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- Practice address
- 1830 Snake River Rd Ste D
Katy, TX 77449-1843 - Phone
- (863) 812-6228
- Fax
- (832) 626-3627
- NPI assigned
- Nov 25, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | Primary |
Addresses
Primary practice location
1830 Snake River Rd Ste D
Katy, TX 77449-1843
Mailing address
20100 Park Row Dr Apt 2102
Katy, TX 77449-4989
Phone (832) 941-2129
Other practice location 1
11500 Northwest Fwy Ste 280
Houston, TX 77092-6521
Phone (863) 812-6228
Other practice location 2
11511 Katy Fwy Ste 406
Houston, TX 77079-1914
Phone (863) 812-6228
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therassage MD, PLLC | Nutrition, Education | Past | Accepting new patients |
| Therassage Medical Solution | Nutrition, Education | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1780288142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20100 PARK ROW DR APT 2102",
"city": "KATY",
"state": "TX",
"postal_code": "774494989",
"telephone_number": "832-941-2129",
"fax_number": "832-626-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 SNAKE RIVER RD STE D",
"city": "KATY",
"state": "TX",
"postal_code": "774491843",
"telephone_number": "863-812-6228",
"fax_number": "832-626-3627"
}
],
"practiceLocations": [
{
"address_1": "11500 Northwest Fwy Ste 280",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770926521",
"country_code": "US",
"telephone_number": "863-812-6228",
"fax_number": "832-626-3627",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11511 Katy Fwy Ste 406",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770791914",
"country_code": "US",
"telephone_number": "863-812-6228",
"fax_number": "832-626-3627",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CASTILLO POLANCO",
"first_name": "JESUS",
"middle_name": "ALBERTO",
"credential": "FNC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-25",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nutritionist, Nutrition, Education",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.