Provider Demographics
NPI:1275508848
Name:CASTANO, CLAUDIA (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:CASTANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 FOREST LN STE 160
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4165
Mailing Address - Country:US
Mailing Address - Phone:972-986-7469
Mailing Address - Fax:214-614-4431
Practice Address - Street 1:3530 FOREST LN STE 160
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-4165
Practice Address - Country:US
Practice Address - Phone:972-986-7469
Practice Address - Fax:214-614-4431
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4647208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124911203Medicaid
TX8A0581OtherBCBS
TXTXB153561Medicare PIN
TXG76520Medicare UPIN