Provider Demographics
NPI:1477895365
Name:CASTATOR, GREGORY EARL (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:EARL
Last Name:CASTATOR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E MILAM ST
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-2445
Mailing Address - Country:US
Mailing Address - Phone:254-562-5123
Mailing Address - Fax:254-562-9519
Practice Address - Street 1:701 E MILAM ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2445
Practice Address - Country:US
Practice Address - Phone:254-562-5123
Practice Address - Fax:254-562-9519
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist