Basic Information
| Provider Information | |||||||||
| NPI: | 1538487921 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASTILLO SUAREZ | ||||||||
| FirstName: | MELANY | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2646 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785022646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563622171 | ||||||||
| FaxNumber: | 9563622574 | ||||||||
| Practice Location | |||||||||
| Address1: | 2609 MICHAELANGELO DR | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785391417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563625650 | ||||||||
| FaxNumber: | 9563622574 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2010 | ||||||||
| LastUpdateDate: | 01/19/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | Q5362 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 350740201 | 05 | TX | MEDICAID |