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General NPI Number Information
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NPI Number | 1003956657
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS SURGICAL GROUP, PA
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 221 W COLORADO BLVD PAV II STE#740
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-948-0475
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Fax | 214-948-6198
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Provider Business Mailing Address
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Address Line | PO BOX 27258
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City | EL PASO
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State | TX
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Zip | 79926-7258
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Country | US
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Telephone | 214-948-0475
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Fax | 214-948-6198
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANUEL E. CASTRO
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Credential | M.D.
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Telephone | 214-948-0475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | J6897
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License Number State | TX
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