Provider Demographics
NPI:1013587419
Name:CASTILLO, OSCAR (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12380 EDGEMERE BLVD. STE 102
Mailing Address - Street 2:PMB# 202
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2626
Mailing Address - Country:US
Mailing Address - Phone:915-534-7979
Mailing Address - Fax:
Practice Address - Street 1:12380 EDGEMERE BLVD. STE 102
Practice Address - Street 2:PMB# 202
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2626
Practice Address - Country:US
Practice Address - Phone:915-534-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045185363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health