MEDICARE: DR. FRANK CASTILLON III M.D.

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	207T00000X	Neurological Surgery Physician	M0682	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8EC855	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	216108100	OTHER	TX	FIRSTCARE

General Provider Information

NPI Number	:	1104866375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK CASTILLON III M.D.

Provider Business Mailing Address
First Line	:	2424 50TH ST
Second Line	:	SUITE 100
City	:	LUBBOCK
State	:	TX
Zip	:	79412-2556
Country	:	US
Telephone Number	:	806-761-0722
Fax Number	:	806-797-1265

Provider Business Practice Location Address
First Line	:	2424 50TH SREET
Second Line	:	STE 100
City	:	LUBBOCK
State	:	TX
Zip	:	79412-2549
Country	:	US
Telephone Number	:	806-761-0722
Fax Number	:	806-797-1265

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	04/26/2016

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