Provider Demographics
NPI:1083918346
Name:CASILLAS, ADAM NOEL (PA-C)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:NOEL
Last Name:CASILLAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8503 NW MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1841
Mailing Address - Country:US
Mailing Address - Phone:210-492-8200
Mailing Address - Fax:
Practice Address - Street 1:8503 NW MILITARY HWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2448
Practice Address - Country:US
Practice Address - Phone:210-492-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant