Provider Demographics
NPI:1083937619
Name:CASTILLO, MARCO A (CART)
Entity Type:Individual
Prefix:MR
First Name:MARCO
Middle Name:A
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 W BUSINESS 83
Mailing Address - Street 2:3801 SUN COUNTRY DR.
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3556
Mailing Address - Country:US
Mailing Address - Phone:956-444-0111
Mailing Address - Fax:956-444-0113
Practice Address - Street 1:3701 W BUSINESS 83
Practice Address - Street 2:3801 SUN COUNTRY DR.
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3556
Practice Address - Country:US
Practice Address - Phone:956-444-0111
Practice Address - Fax:956-444-0113
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2524-2142101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist