Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 19165 | TX |
NPI | 1134283526 |
---|---|
Provider Name | Dr. Alexy F Aviles |
First Address | Houston, TX 77096-3856 |
Second Address | Houston, TX 77096-3856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |