Provider Demographics
NPI:1275935355
Name:CASTANEDA, ADAN RENE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADAN
Middle Name:RENE
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 GUADALUPE ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5248
Mailing Address - Country:US
Mailing Address - Phone:956-727-0178
Mailing Address - Fax:956-727-2657
Practice Address - Street 1:1119 GUADALUPE ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5248
Practice Address - Country:US
Practice Address - Phone:956-727-0178
Practice Address - Fax:956-727-2657
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2014-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist