Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | M0682 | TX |
NPI | 1104866375 |
---|---|
Provider Name | Dr. Frank Castillon III |
First Address | Lubbock, TX 79412-2556 |
Second Address | Lubbock, TX 79412-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 26/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
216108100 | FIRSTCARE (01) | TX |
51953072 | (05) | NM |
8EC855 | BCBS (01) | TX |