Individual
BARRY A CASTANEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05760
TX
363AS0400X
Surgical Physician Assistant
PA05760
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042932
BLUE CROSS BLUE SHIELD
KS
05
—
100346760B
—
KS
Enumeration date
07/26/2006
Last updated
08/11/2022
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