Individual
AUSTIN CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1244
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1244
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
S9857
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424879101
—
TX
Enumeration date
03/28/2019
Last updated
07/30/2021
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