Provider Demographics
NPI:1992310973
Name:FERNANDO CASTANEDA MD PA
Entity type:Organization
Organization Name:FERNANDO CASTANEDA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-795-8255
Mailing Address - Street 1:4151 JAIME ZAPATA HWY SUITE 102
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043
Mailing Address - Country:US
Mailing Address - Phone:956-795-8255
Mailing Address - Fax:
Practice Address - Street 1:4151 JAIME ZAPATA HWY SUITE 102
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043
Practice Address - Country:US
Practice Address - Phone:956-795-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty