Provider Demographics
NPI:1073116216
Name:CASTILLO, EUGENIO ENRIQUE (PHARMD)
Entity Type:Individual
Prefix:
First Name:EUGENIO
Middle Name:ENRIQUE
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 SANTA MONICA ST
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-3459
Mailing Address - Country:US
Mailing Address - Phone:361-522-3103
Mailing Address - Fax:
Practice Address - Street 1:1118 S. HIGHWAY 281 BUSINESS
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355
Practice Address - Country:US
Practice Address - Phone:361-323-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist