Provider Demographics
NPI:1922247881
Name:CASTILLO, BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7487 BROMPTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2265
Mailing Address - Country:US
Mailing Address - Phone:713-667-9896
Mailing Address - Fax:
Practice Address - Street 1:13176 W LAKE HOUSTON PKWY
Practice Address - Street 2:STE. 5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-5390
Practice Address - Country:US
Practice Address - Phone:281-436-0061
Practice Address - Fax:281-436-1128
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine