MEDICARE: BLANCA ALEJANDRA CASTRO MSN, APRN

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	363LF0000X	Family Nurse Practitioner	AP132173	TX

General Provider Information

NPI Number	:	1639614662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLANCA ALEJANDRA CASTRO MSN, APRN

Provider Business Mailing Address
First Line	:	320 ALTOZANO DR
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6864
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6999 MCPHERSON RD STE 220
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-6451
Country	:	US
Telephone Number	:	956-795-4776
Fax Number	:

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

Provider Enumeration Date	:	12/29/2016
Last Update Date	:	08/16/2021

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