Provider Demographics
NPI:1881163087
Name:CASTRO RIOS, REBECCA ELAINE (FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELAINE
Last Name:CASTRO RIOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ELAINE
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4212 E SOUTHCROSS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3735
Mailing Address - Country:US
Mailing Address - Phone:210-527-1505
Mailing Address - Fax:
Practice Address - Street 1:4212 E SOUTHCROSS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3735
Practice Address - Country:US
Practice Address - Phone:210-527-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1881163087OtherCMS