MEDICARE: DAVID MARTIN CASTANDA R.PH.

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	1835C0207X	Compounded Sterile Preparations Pharmacist	30082	TX
2	183500000X	Pharmacist	30082	TX

General Provider Information

NPI Number	:	1770307654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MARTIN CASTANDA R.PH.

Provider Business Mailing Address
First Line	:	9734 KELTON DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-3155
Country	:	US
Telephone Number	:	210-875-7655
Fax Number	:

Provider Business Practice Location Address
First Line	:	10811 TOWN CENTER DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4585
Country	:	US
Telephone Number	:	210-572-0911
Fax Number	:

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

Provider Enumeration Date	:	11/08/2024
Last Update Date	:	11/08/2024

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Directions to “ DAVID MARTIN CASTANDA R.PH.” Practice Location

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