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NPI Code Detail

MEDICARE: TEODORO A CASTILLO M.D.

MEDICARE: TEODORO A CASTILLO 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
1208100000XPhysical Medicine & Rehabilitation PhysicianK4868TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K4868OTHERTXMEDICAL LICENSE

General Provider Information

NPI Number : 1518914910
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEODORO A CASTILLO M.D.
Provider Business Mailing Address
First Line : PO BOX 200903
Second Line :
City : HOUSTON
State : TX
Zip : 77216-0903
Country : US
Telephone Number : 281-252-9993
Fax Number : 281-252-9997
Provider Business Practice Location Address
First Line : 1333 MOURSUND ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-3405
Country : US
Telephone Number : 713-799-5052
Fax Number : 713-799-7052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2006
Last Update Date : 07/26/2007

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Directions to “ TEODORO A CASTILLO M.D.” Practice Location

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