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General NPI Number Information
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NPI Number | 1316343379
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Entity Type | Organization
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Legal Business Name | RGVSLEEP, LLC
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 900 PLAZA DR SUITE #3
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City | MISSION
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State | TX
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Zip | 78572-6045
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Country | US
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Telephone | 956-584-1554
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Fax | 956-584-0383
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Provider Business Mailing Address
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Address Line | 900 PLAZA DR SUITE #3
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City | MISSION
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State | TX
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Zip | 78572-6045
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Country | US
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Telephone | 956-584-1554
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Fax | 956-584-0383
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Authorized Official
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Title or Position | OWNER
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Name | DR. MIGUEL CASTILLO III
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Credential | D.D.S. P.A.
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Telephone | 956-584-1554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 19222
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License Number State | TX
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