Provider Demographics
NPI:1528184975
Name:TAMMY Y. KASTRE M.D., P.C.
Entity Type:Organization
Organization Name:TAMMY Y. KASTRE M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:KASTRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-498-1360
Mailing Address - Street 1:205 W GIACONDA WAY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4349
Mailing Address - Country:US
Mailing Address - Phone:520-498-1360
Mailing Address - Fax:520-498-1364
Practice Address - Street 1:205 W GIACONDA WAY
Practice Address - Street 2:SUITE 115
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4349
Practice Address - Country:US
Practice Address - Phone:520-498-1360
Practice Address - Fax:520-498-1364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22002261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF73654Medicare UPIN
AZ75391Medicare ID - Type Unspecified