Provider Demographics
NPI:1851375422
Name:CASTRO-ANDRES, GRACE H (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:H
Last Name:CASTRO-ANDRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 N BRITAIN RD
Practice Address - Street 2:IRVING HEALTH CENTER
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2630
Practice Address - Country:US
Practice Address - Phone:214-266-3000
Practice Address - Fax:214-266-3049
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7445207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138908211Medicaid
TX138908212Medicaid
TX138908205Medicaid
TX138908210Medicaid
TX138908203Medicaid
TX110200810OtherRAILROAD MEDICARE
TX138908206Medicaid
TX138908207Medicaid
TX138908214Medicaid
TX138908204Medicaid
TX138908208Medicaid
TX138908213Medicaid
TX87W583OtherBLUE CROSS BLUE SHIELD
TX138908201Medicaid
TX138908202Medicaid
TX138908201Medicaid
TX110200810OtherRAILROAD MEDICARE