Provider Demographics
NPI:1245457860
Name:RAUL CASTILLO ECONOMY PHARMACY NO 3
Entity type:Organization
Organization Name:RAUL CASTILLO ECONOMY PHARMACY NO 3
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-924-5528
Mailing Address - Street 1:305 PEABODY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-2901
Mailing Address - Country:US
Mailing Address - Phone:210-924-5528
Mailing Address - Fax:210-924-0280
Practice Address - Street 1:305 PEABODY AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-2901
Practice Address - Country:US
Practice Address - Phone:210-924-5528
Practice Address - Fax:210-924-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4530350Medicaid