MEDICARE: HOMERO CASTILLO

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	246ZC0007X	Surgical Assistant	SA00509	TX

General Provider Information

NPI Number	:	1932445863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOMERO CASTILLO

Provider Business Mailing Address
First Line	:	8000 WEST AVE # I-10
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1837
Country	:	US
Telephone Number	:	210-525-7929
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 WEST AVE # I-10
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1837
Country	:	US
Telephone Number	:	210-525-7929
Fax Number	:

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

Provider Enumeration Date	:	12/20/2012
Last Update Date	:	11/19/2014

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Directions to “ HOMERO CASTILLO ” Practice Location

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