MEDICARE: DR. DIANA PATRICIA CASTRO 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	390200000X	Student in an Organized Health Care Education/Training Program
2	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	P3866	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	:	1750554689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA PATRICIA CASTRO MD

Provider Business Mailing Address
First Line	:	660 W PENINSULA DR
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-6801
Country	:	US
Telephone Number	:	917-837-2351
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 S MAYHILL RD STE 115
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-5967
Country	:	US
Telephone Number	:	972-634-2931
Fax Number	:	469-923-0791

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

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	09/07/2022

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