Provider Demographics
NPI:1699427534
Name:CASTILLO, HERMAN (NP)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:NP
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 1470
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-1470
Mailing Address - Country:US
Mailing Address - Phone:830-773-8917
Mailing Address - Fax:830-773-1892
Practice Address - Street 1:4018 EL INDIO HWY
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6690
Practice Address - Country:US
Practice Address - Phone:830-872-3460
Practice Address - Fax:830-872-3470
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAPRN1056588OtherTEXAS BOARD OF NURSING
TXF09210606OtherAMERICA ACADEMY OF NURSE PRACTITIONERS
TX863218OtherTEXAS BOARD OF NURSING