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NPI Code Detail

MEDICARE: RUBEN CASTRO LCSW

MEDICARE: RUBEN CASTRO LCSW
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
11041C0700XClinical Social Worker62856TX

General Provider Information

NPI Number : 1770319287
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBEN CASTRO LCSW
Provider Business Mailing Address
First Line : 603 E CONVENT ST
Second Line :
City : VICTORIA
State : TX
Zip : 77901-8235
Country : US
Telephone Number : 210-630-5918
Fax Number :
Provider Business Practice Location Address
First Line : 802 E CRESTWOOD DR
Second Line :
City : VICTORIA
State : TX
Zip : 77901-3309
Country : US
Telephone Number : 361-576-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2024
Last Update Date : 09/11/2024

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Directions to “ RUBEN CASTRO LCSW” Practice Location

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