Provider Demographics
NPI:1275797680
Name:RAMIREZ CASTANEDA, JUAN LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:LUIS
Last Name:RAMIREZ CASTANEDA
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 1:250 E BASSE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-8409
Mailing Address - Country:US
Mailing Address - Phone:210-874-3270
Mailing Address - Fax:210-874-3271
Practice Address - Street 1:250 E BASSE RD STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-8409
Practice Address - Country:US
Practice Address - Phone:210-874-3270
Practice Address - Fax:210-874-3271
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP78382084N0400X
TXBP10031447207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX331333003Medicaid
TX331333004OtherCSHCN
TX331333004OtherCSHCN