Provider Demographics
NPI:1750554689
Name:CASTRO, DIANA PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:PATRICIA
Last Name:CASTRO
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 1:660 W PENINSULA DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-6801
Mailing Address - Country:US
Mailing Address - Phone:917-837-2351
Mailing Address - Fax:
Practice Address - Street 1:2817 S MAYHILL RD STE 115
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-5967
Practice Address - Country:US
Practice Address - Phone:972-634-2931
Practice Address - Fax:469-923-0791
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP38662084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1750554689Medicaid