Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | F-6380 | TX |
NPI | 1164492120 |
---|---|
Provider Name | Dr. Raul Alfonso Aguilar |
First Address | Edinburg, TX 78539-5524 |
Second Address | Lackland Afb, TX 78236-5300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 08/07/2007 |