MEDICARE: CESARIO A CASTILLO MD PA

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0097NG	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588761589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CESARIO A CASTILLO MD PA

Provider Business Mailing Address
First Line	:	13176 W LAKE HOUSTON PKWY
Second Line	:	SUITE 5
City	:	HOUSTON
State	:	TX
Zip	:	77044-5390
Country	:	US
Telephone Number	:	281-436-0061
Fax Number	:	281-436-1128

Provider Business Practice Location Address
First Line	:	13176 W LAKE HOUSTON PKWY
Second Line	:	SUITE 5
City	:	HOUSTON
State	:	TX
Zip	:	77044-5390
Country	:	US
Telephone Number	:	281-436-0061
Fax Number	:	281-436-1128

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MRS. DOAN T. CASTILLO
Credential	:	R.PH
Telephone Number	:	281-436-0061

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/25/2012

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Directions to “CESARIO A CASTILLO MD PA ” Practice Location

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