Provider Demographics
NPI:1134186166
Name:CASTILLO, RENE ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:ALBERTO
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:4101 JAMES CASEY ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1145
Practice Address - Country:US
Practice Address - Phone:512-447-2202
Practice Address - Fax:512-447-5337
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.12610R207RH0003X
TXM3964207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00662892OtherRAILROAD MEDICARE
TX8BP223OtherBCBS OF TX
TX182873303Medicaid
TX182873302Medicaid
TXP00662592OtherRAILROAD MEDICARE
TXF99694Medicare UPIN
TX182873303Medicaid
TXP00662892OtherRAILROAD MEDICARE