Provider Demographics
NPI:1184695488
Name:CASTILLO, GREGORIO JOEL ASUNCION (MD)
Entity type:Individual
Prefix:
First Name:GREGORIO JOEL
Middle Name:ASUNCION
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 1:10501 VISTA DEL SOL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7940
Mailing Address - Country:US
Mailing Address - Phone:915-592-8880
Mailing Address - Fax:915-592-8883
Practice Address - Street 1:10501 VISTA DEL SOL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7940
Practice Address - Country:US
Practice Address - Phone:915-592-8880
Practice Address - Fax:915-592-8883
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8950207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C2256Medicare PIN
TXG10718Medicare UPIN