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General NPI Number Information
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NPI Number | 1558323717
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Entity Type | Organization
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Legal Business Name | WOMEN'S WELLNESS & HEALTHCARE CLINIC
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 1710 E. SAUNDERS SUITE A200
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City | LAREDO
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State | TX
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Zip | 78041-2213
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Country | US
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Telephone | 956-753-7600
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Fax | 956-753-7800
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Provider Business Mailing Address
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Address Line | 1710 E. SAUNDERS SUITE A200
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City | LAREDO
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State | TX
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Zip | 78041-2213
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Country | US
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Telephone | 956-753-7600
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Fax | 956-753-7800
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICARDO CASTILLON
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Credential | M.D.
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Telephone | 956-753-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K9748
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License Number State | TX
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