Provider Demographics
NPI:1700466257
Name:CASTRO, VERONICA JEANETTE
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:JEANETTE
Last Name:CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5664
Mailing Address - Country:US
Mailing Address - Phone:956-380-6219
Mailing Address - Fax:866-537-7905
Practice Address - Street 1:1212 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5664
Practice Address - Country:US
Practice Address - Phone:956-380-6219
Practice Address - Fax:866-537-7905
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161620183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician