MEDICARE: DR. FERNANDO ANGEL CASTANEDA M.D.

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
1	208000000X	Pediatrics Physician	K2319	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0052JE	OTHER	BC BS #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568467363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERNANDO ANGEL CASTANEDA M.D.

Provider Business Mailing Address
First Line	:	4151 LOOP 20
Second Line	:	STE 102
City	:	LAREDO
State	:	TX
Zip	:	78043-4741
Country	:	US
Telephone Number	:	956-795-8255
Fax Number	:	956-795-8257

Provider Business Practice Location Address
First Line	:	4151 JAIME ZAPATA HWY
Second Line	:	STE 102
City	:	LAREDO
State	:	TX
Zip	:	78043-4741
Country	:	US
Telephone Number	:	956-795-8255
Fax Number	:	956-795-8257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/27/2024

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Directions to “ DR. FERNANDO ANGEL CASTANEDA M.D.” Practice Location

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