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Luis Enrique Malpica Castillo

Internal Medicine

Allopathic & Osteopathic Physicians

1515 Holcombe Blvd, Houston, TX 77030-4000

PECOS Enrollment

This provider is enrolled in PECOS as LUIS MALPICA CASTILLO.

Based on the most recent information from CMS, provider Luis Enrique Malpica Castillo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:24 AM.

Profile Details

Provider ID
1578977252
Provider Type
Individual
Full Name
Malpica Castillo, Luis Enrique
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/20/2014
Last Updated
10/12/2020

Contact Information

Practice Location

1515 Holcombe Blvd, Houston, TX 77030-4000

(713) 792-6161

Unlisted Fax

Mailing Location

PO Box 4439, Houston, TX 77210-4439

(713) 792-2991

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RH0003X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License S5695 Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License TRN20548 Florida

Provider Identifiers

ID	Description	Issuer
ID 414600301	Description Medicaid	Issuer Unlisted Texas
ID 414600302	Description Other	Issuer OTHER CSHCN TPI Texas

Luis Enrique Malpica Castillo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Hassan, Amy Aida

Marconescu, Andrei

Ishizawa, Jo

Bouligny, Ian

Patel, Shivani C

An, Amy

Bose, Prithviraj

Oki, Yasuhiro

Montalban Bravo, Guillermo

Sathyanarayanan, Vishwanath