Provider Demographics
NPI:1194929927
Name:CASTELLANOS, SARA HOLZBAUER DE (DO)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:HOLZBAUER DE
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 N GRAHAM ST STE 4
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-3100
Mailing Address - Country:US
Mailing Address - Phone:254-965-1156
Mailing Address - Fax:
Practice Address - Street 1:725 N GRAHAM ST STE 4
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-3100
Practice Address - Country:US
Practice Address - Phone:254-965-1156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8110207V00000X
MI5101017199207V00000X
TXT2340207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology