Healthcare Provider Details

I. General information

NPI: 1083547731
Provider Name (Legal Business Name): BIANCA CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 HARRY HINES BLVD
DALLAS TX
75235-5202
US

IV. Provider business mailing address

6201 HARRY HINES BLVD
DALLAS TX
75235-5202
US

V. Phone/Fax

Practice location:
  • Phone: 214-633-5555
  • Fax:
Mailing address:
  • Phone: 214-633-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number42190
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1239702
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: