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NPI Code Detail

MEDICARE: JOSEPH LEE KASTIGAR

MEDICARE: JOSEPH LEE KASTIGAR
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1174143051
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH LEE KASTIGAR
Provider Business Mailing Address
First Line : 26229 NORTH CRANES MILL ROD
Second Line :
City : CANYON LAKE
State : TX
Zip : 78133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26229 N CRANES MILL RD
Second Line :
City : CANYON LAKE
State : TX
Zip : 78133-1957
Country : US
Telephone Number : 830-935-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2020
Last Update Date : 04/21/2020

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Directions to “ JOSEPH LEE KASTIGAR ” Practice Location

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