Individual
DR. ANTONIO A. CASTANEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE, STE 777, FORT WORTH, TX 76104-2144
(817) 698-9700
(817) 698-9703
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 698-9703
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K2318
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104582505
—
TX
01
—
P00464339
RAIL ROAD MEDICARE
TX
Enumeration date
05/17/2006
Last updated
10/04/2011
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