Provider Demographics
NPI:1083610042
Name:CASTRO, WILLIAM HENRY (MD, FACOG)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD, FACOG
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 697
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0697
Mailing Address - Country:US
Mailing Address - Phone:623-363-0721
Mailing Address - Fax:
Practice Address - Street 1:500 AVE DEGETAU
Practice Address - Street 2:HIMA PLAZA 1, SUITE 301
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7301
Practice Address - Country:US
Practice Address - Phone:787-653-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2011-09-28
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
AZ18402207VG0400X
PR17160207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ288747Medicaid
AZ288747Medicaid
AZZMD18402Medicare PIN