MEDICARE: EDMUNDO DEL CASTILLO IDC

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	1710I1002X	Independent Duty Corpsman

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1710I002X	OTHER	TX	IDC

General Provider Information

NPI Number	:	1962618363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDMUNDO DEL CASTILLO IDC

Provider Business Mailing Address
First Line	:	2250 STANLEY RD STE 36
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-6111
Country	:	US
Telephone Number	:	210-221-6492
Fax Number	:	210-221-7393

Provider Business Practice Location Address
First Line	:	2250 STANLEY RD STE 36
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-6111
Country	:	US
Telephone Number	:	210-221-6492
Fax Number	:	210-221-7393

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

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1194939579 — WAYNE PETER BROWN L.C.S.W.
Practice Location Address:

1467 NE 56TH ST , SUITE 2
FORT LAUDERDALE, FL
33334-6111

Practice Phone: 954-536-8257
Practice Fax: 954-963-7169

1265763734 — VIRGINIA PAT MURPHY LCSW
Practice Location Address:

6111 AVERY DR APT 2210
FORT WORTH, TX
76132-3890

Practice Phone: 214-729-4373
Practice Fax:

1720410475 — MARY SULLIVAN MFT
Practice Location Address:

4333 CORBETT DR # 1196
FORT COLLINS, CO
80525-6111

Practice Phone: 970-310-3406
Practice Fax:

1689081374 — STEPHANIE DUTSON
Practice Location Address:

4333 CORBETT DR # 1104
FORT COLLINS, CO
80525-6111

Practice Phone: 205-213-2571
Practice Fax:

1326719519 — OPTIMUM CARE SWFL, INC
Practice Location Address:

2023 CANAL ST
FORT MYERS, FL
33901-6111

Practice Phone: 239-202-2302
Practice Fax: 321-655-7349

1881303139 — MRS. CARISSA KAPPERMAN RD
Practice Location Address:

4333 CORBETT DR # 1240
FORT COLLINS, CO
80525-6111

Practice Phone: 970-415-3015
Practice Fax:

Directions to “ EDMUNDO DEL CASTILLO IDC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.