Provider Demographics
NPI:1487800504
Name:MIGUEL E. CASTELLANOS, M.D., P.A.
Entity type:Organization
Organization Name:MIGUEL E. CASTELLANOS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-886-7245
Mailing Address - Street 1:610 STRICKLAND DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4788
Mailing Address - Country:US
Mailing Address - Phone:409-886-7245
Mailing Address - Fax:409-883-7450
Practice Address - Street 1:610 STRICKLAND DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4788
Practice Address - Country:US
Practice Address - Phone:409-886-7245
Practice Address - Fax:409-883-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9311207RC0000X
207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA16918Medicare UPIN