Provider Demographics
NPI:1215946025
Name:NEWCO, WOMEN'S MEDICAL CENTER
Entity type:Organization
Organization Name:NEWCO, WOMEN'S MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:F
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-366-7233
Mailing Address - Street 1:515 WESTBANK EXPY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-5644
Mailing Address - Country:US
Mailing Address - Phone:504-366-7233
Mailing Address - Fax:504-366-0686
Practice Address - Street 1:515 WESTBANK EXPY
Practice Address - Street 2:SUITE 7
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5644
Practice Address - Country:US
Practice Address - Phone:504-366-7233
Practice Address - Fax:504-366-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0034809207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LACH5429OtherRAILROAD MEDICARE
LA1441325Medicaid
LACH5429OtherRAILROAD MEDICARE