MEDICARE: ALEX EDUARDO CASTILLO LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT114302	TX

General Provider Information

NPI Number	:	1023844768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX EDUARDO CASTILLO LMT

Provider Business Mailing Address
First Line	:	7557 RAMBLER RD STE 720
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2388
Country	:	US
Telephone Number	:	214-361-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	8109 SKILLMAN ST APT 3007
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2828
Country	:	US
Telephone Number	:	214-533-6468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2024
Last Update Date	:	09/10/2024

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Directions to “ ALEX EDUARDO CASTILLO LMT” Practice Location

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