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NPI Code Detail

MEDICARE: EVA MARIE CASTRO

MEDICARE: EVA MARIE CASTRO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner510960TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538204052
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVA MARIE CASTRO
Provider Business Mailing Address
First Line : PO BOX 848491
Second Line :
City : DALLAS
State : TX
Zip : 75284-8491
Country : US
Telephone Number : 254-202-9330
Fax Number : 254-202-9349
Provider Business Practice Location Address
First Line : 120 HILLCREST MEDICAL BLVD STE 100
Second Line :
City : WACO
State : TX
Zip : 76712-8949
Country : US
Telephone Number : 254-202-6100
Fax Number : 254-202-6195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 12/06/2021

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Directions to “ EVA MARIE CASTRO ” Practice Location

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