Provider Demographics
NPI:1457521478
Name:CASTASUS, MANUEL ALMENDRAL
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ALMENDRAL
Last Name:CASTASUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12635 CONWAY DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8106
Mailing Address - Country:US
Mailing Address - Phone:314-434-8567
Mailing Address - Fax:
Practice Address - Street 1:884 WOODSMILL ROAD
Practice Address - Street 2:TTG LOCUM TENENS
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011
Practice Address - Country:US
Practice Address - Phone:636-841-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO330702086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery