Provider Demographics
NPI:1730183179
Name:CASTANEDA, HUGO (MD)
Entity type:Individual
Prefix:DR
First Name:HUGO
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 W HOUSTON ST
Mailing Address - Street 2:SUITE # 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2107
Mailing Address - Country:US
Mailing Address - Phone:210-223-2601
Mailing Address - Fax:210-226-6395
Practice Address - Street 1:343 W HOUSTON ST
Practice Address - Street 2:SUITE # 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2107
Practice Address - Country:US
Practice Address - Phone:210-223-2601
Practice Address - Fax:210-226-6395
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5855174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099226501Medicaid
TXB21731Medicare UPIN
TX099226501Medicaid