Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 1045185 | TX |
NPI | 1013587419 |
---|---|
Provider Name | Mr. Oscar Castillo |
First Address | El Paso, TX 79938-2626 |
Second Address | El Paso, TX 79938-2626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2021 |
Last Update Date | 28/06/2021 |