Provider Demographics
NPI:1407807886
Name:CASILLAS, GASTON LHEBRARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GASTON
Middle Name:LHEBRARD
Last Name:CASILLAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1213 HERMANN DR
Mailing Address - Street 2:SUITE 460
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7018
Mailing Address - Country:US
Mailing Address - Phone:713-807-0505
Mailing Address - Fax:713-807-0508
Practice Address - Street 1:1213 HERMANN DR
Practice Address - Street 2:SUITE 460
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7018
Practice Address - Country:US
Practice Address - Phone:713-807-0505
Practice Address - Fax:713-807-0508
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK5078208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030906401Medicaid
TX030906401Medicaid
TXF32441Medicare UPIN