Provider Demographics
NPI:1467240333
Name:DE CASTRO, PEDRO CAMPOS
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:CAMPOS
Last Name:DE CASTRO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19555 S RENNER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66083-8761
Mailing Address - Country:US
Mailing Address - Phone:402-917-7259
Mailing Address - Fax:
Practice Address - Street 1:19555 S RENNER RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-8761
Practice Address - Country:US
Practice Address - Phone:402-917-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program