Provider Demographics
NPI:1063401776
Name:CASTILLO, JAMES WALTER II (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WALTER
Last Name:CASTILLO
Suffix:II
Gender:M
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:569-362-3795
Mailing Address - Fax:569-362-3793
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:956-362-7253
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1041207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177737702Medicaid
TX177737703Medicaid
TX8D9154Medicare PIN
TX177737702Medicaid
TX8J1441Medicare PIN