Provider Demographics
NPI:1841509163
Name:MOLLEDA CASTRO, IMGARD CAROLINA (MD)
Entity type:Individual
Prefix:
First Name:IMGARD
Middle Name:CAROLINA
Last Name:MOLLEDA 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 1:3720 COLLEGE PARK DR
Mailing Address - Street 2:13101
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4815
Mailing Address - Country:US
Mailing Address - Phone:936-242-1561
Mailing Address - Fax:
Practice Address - Street 1:3720 COLLEGE PARK DR
Practice Address - Street 2:13101
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4815
Practice Address - Country:US
Practice Address - Phone:936-242-1561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7844208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics