Provider Demographics
NPI:1376792978
Name:A LOUIS OJASCASTRO LLC
Entity Type:Organization
Organization Name:A LOUIS OJASCASTRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:OJASCASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-846-9090
Mailing Address - Street 1:5715 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-4221
Mailing Address - Country:US
Mailing Address - Phone:314-846-9090
Mailing Address - Fax:314-846-2968
Practice Address - Street 1:5715 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-4221
Practice Address - Country:US
Practice Address - Phone:314-846-9090
Practice Address - Fax:314-846-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3J90207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202678306Medicare UPIN
MO00005220Medicare PIN
MOE08990Medicare UPIN