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General NPI Number Information
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NPI Number | 1609385814
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Entity Type | Individual
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Provider Name | LUIS V CASTRO PT
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Gender | Male
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 110 N JERRY CLOWER BLVD STE M
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City | YAZOO CITY
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State | MS
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Zip | 39194-8669
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Country | US
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Telephone | 662-763-3750
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Fax | 662-763-3721
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Provider Business Mailing Address
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Address Line | PO BOX 2153 DEPT 1947
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City | BIRMINGHAM
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State | AL
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Zip | 35287-1689
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Country | US
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Telephone | 901-227-3255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6262
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License Number State | MS
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