Provider Demographics
NPI:1831373968
Name:DR. MIGUEL CASTILLO, III, D.D.S, P.A.
Entity type:Organization
Organization Name:DR. MIGUEL CASTILLO, III, D.D.S, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-584-3125
Mailing Address - Street 1:900 PLAZA DR STE 3
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6049
Mailing Address - Country:US
Mailing Address - Phone:956-584-3125
Mailing Address - Fax:956-584-0383
Practice Address - Street 1:900 PLAZA DR STE 3
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6049
Practice Address - Country:US
Practice Address - Phone:956-584-3125
Practice Address - Fax:956-584-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty