Provider Demographics
NPI:1295787778
Name:CASTILLO, CATHY A (MD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:CASTILLO
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 1:4500 WILLIAMS DR
Mailing Address - Street 2:STE 285
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-1339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:15803 WINDERMERE DR STE 102
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2482
Practice Address - Country:US
Practice Address - Phone:512-989-2680
Practice Address - Fax:512-406-7339
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2279207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177278202Medicaid
TX177278204Medicaid
TX177278203Medicaid
TX177278206Medicaid
TX177278202Medicaid
TX8J0071Medicare PIN
TXP00366345Medicare PIN