Provider Demographics
NPI:1326159799
Name:CASTRO, REBECCA (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CASTRO
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 1:1331 E COURT ST STE 106
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5167
Mailing Address - Country:US
Mailing Address - Phone:830-401-7367
Mailing Address - Fax:830-372-5858
Practice Address - Street 1:1331 E COURT ST STE 106
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5167
Practice Address - Country:US
Practice Address - Phone:830-401-7367
Practice Address - Fax:830-372-5858
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXH89742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2816493OtherBLUE CROSS BLUE SHIELD
TX2816493OtherBLUE CROSS BLUE SHIELD