Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | M1041 | TX |
NPI | 1063401776 |
---|---|
Provider Name | James Walter Castillo II |
First Address | Pharr, TX 78577-1614 |
Second Address | Edinburg, TX 78539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 19/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
177737702 | (05) | TX |
177737703 | (05) | TX |
I42036 | (02) | TX |