Provider Demographics
NPI:1497771166
Name:CASTILLO, ROBERT (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8042 WURZBACH RD STE 450
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3808
Mailing Address - Country:US
Mailing Address - Phone:210-899-1026
Mailing Address - Fax:210-348-9130
Practice Address - Street 1:1314 E SONTERRA BLVD STE 302
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-899-1026
Practice Address - Fax:210-495-0242
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1741213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J1316OtherBCBS
TX7684715OtherAETNA
TX191314701Medicaid
TXV05919Medicare UPIN
TX8D7867Medicare ID - Type UnspecifiedMEDICARE PROVIDER#
TX191314701Medicaid