MEDICARE: MR. ROBERT MANUEL CASTILLO MD

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	208D00000X	General Practice Physician	G1817	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396799128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT MANUEL CASTILLO MD

Provider Business Mailing Address
First Line	:	PO BOX 70109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77270-0109
Country	:	US
Telephone Number	:	713-869-4631
Fax Number	:	713-869-8148

Provider Business Practice Location Address
First Line	:	4302 CENTER STREET
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5616
Country	:	US
Telephone Number	:	713-869-4631
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	12/23/2009

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