Healthcare Provider Details

I. General information

NPI: 1477728657
Provider Name (Legal Business Name): CESAR AUGUSTO CASTILLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

5117 JACKSON ST
HOUSTON TX
77004-5922
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-2900
  • Fax:
Mailing address:
  • Phone: 617-230-3544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberP8228
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberP8228
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: