Provider Demographics
NPI:1609875558
Name:CASILLAS, ARTURO
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:CASILLAS
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 1:1400 N EL PASO ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3438
Mailing Address - Country:US
Mailing Address - Phone:915-577-0444
Mailing Address - Fax:915-577-0509
Practice Address - Street 1:1400 N EL PASO ST
Practice Address - Street 2:BLDG. E
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3437
Practice Address - Country:US
Practice Address - Phone:915-577-0444
Practice Address - Fax:915-577-0509
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6056208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF79741Medicare UPIN