Provider Demographics
NPI:1811344583
Name:CASTILLO, ROMAN ADONIS (MD)
Entity type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:ADONIS
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2121 S BUCKNER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8602
Mailing Address - Country:US
Mailing Address - Phone:214-381-1187
Mailing Address - Fax:214-381-7213
Practice Address - Street 1:2121 S BUCKNER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8602
Practice Address - Country:US
Practice Address - Phone:214-381-1187
Practice Address - Fax:214-381-7213
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2253207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine