Organization Active NPI

Robert Manuel Castillo

Doing business as Center Street Medical Clinic

  • General Practice Physician
  • Houston, TX
National Provider Identifier
1770628570
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G1817 Issued in TX
Legal business name
ROBERT MANUEL CASTILLO
Doing business as
Center Street Medical Clinic
Practice address
4302 Center Street
Houston, TX 77007-5616
Phone
(713) 869-4631
Fax
(713) 869-8148
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Sonia Cruz
Title
Office Administrator
Phone
(832) 788-8135

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X G1817 TX
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X G1817 TX Primary

Addresses

Primary practice location

4302 Center Street
Houston, TX 77007-5616

Mailing address

PO Box 70109
Houston, TX 77270-0109
Phone (713) 869-4631

Other identifiers 2

IdentifierTypeStateIssuer
162706902MedicaidTX
162706901MedicaidTX

Other names 1

  • Center Street Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

4302 Center St
Houston, TX 77007
Phone (713) 864-0808

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1770628570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70109",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772700109",
            "telephone_number": "713-869-4631",
            "fax_number": "713-869-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 CENTER STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770075616",
            "telephone_number": "713-869-4631",
            "fax_number": "713-869-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT MANUEL CASTILLO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "OFFICE  ADMINISTRATOR",
        "authorized_official_telephone_number": "832-788-8135",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G1817",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "G1817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162706902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162706901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center Street Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.