Provider Demographics
NPI:1487719290
Name:CASTANEDA, FRANK (RPH)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 SAN DARIO AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-7207
Mailing Address - Country:US
Mailing Address - Phone:956-722-1205
Mailing Address - Fax:
Practice Address - Street 1:7501 SAN DARIO AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-7207
Practice Address - Country:US
Practice Address - Phone:956-722-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17227183500000X
TX27863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144461Medicaid