Provider Demographics
NPI:1346829611
Name:CASTANEDA, HECTOR BRIAN (CSFA)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:BRIAN
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4135
Mailing Address - Country:US
Mailing Address - Phone:830-370-5678
Mailing Address - Fax:
Practice Address - Street 1:611 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4135
Practice Address - Country:US
Practice Address - Phone:830-370-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
TX201836246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty