Provider Demographics
NPI:1609171396
Name:CASTANEDA, VONDA LANE (PA)
Entity type:Individual
Prefix:MRS
First Name:VONDA
Middle Name:LANE
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:VONDA
Other - Middle Name:LANE
Other - Last Name:FINKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7120 OLDHAM PL
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-5019
Mailing Address - Country:US
Mailing Address - Phone:979-820-2207
Mailing Address - Fax:
Practice Address - Street 1:R3 WOUND CARE & HYPERBARICS
Practice Address - Street 2:4150 N COLLINS ST
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76005
Practice Address - Country:US
Practice Address - Phone:817-337-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07169363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant