Provider Demographics
NPI:1003956657
Name:NEW BEGINNINGS SURGICAL GROUP, PA
Entity Type:Organization
Organization Name:NEW BEGINNINGS SURGICAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-948-0475
Mailing Address - Street 1:PO BOX 27258
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79926-7258
Mailing Address - Country:US
Mailing Address - Phone:214-948-0475
Mailing Address - Fax:214-948-6198
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAV II STE#740
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-948-0475
Practice Address - Fax:214-948-6198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6897208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X705OtherMEDICARE GROUP PTAN
TX00Z666OtherMEDICARE GROUP PTAN
TX190066401Medicaid
TX1973307Medicaid