Provider Demographics
NPI:1114547841
Name:CASTILLO, ISAAC ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:ANTHONY
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0165
Mailing Address - Country:US
Mailing Address - Phone:409-747-5727
Mailing Address - Fax:409-747-5715
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0165
Practice Address - Country:US
Practice Address - Phone:409-747-5727
Practice Address - Fax:409-747-5715
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program