Provider Demographics
NPI:1609351840
Name:CASTRO, MANUEL CRISTOBAL
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:CRISTOBAL
Last Name:CASTRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 EMERALD ISLE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3980
Mailing Address - Country:US
Mailing Address - Phone:972-603-8383
Mailing Address - Fax:
Practice Address - Street 1:1010 EMERALD ISLE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3980
Practice Address - Country:US
Practice Address - Phone:214-321-8421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist