Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 32201 | AZ |
N | 2080P0203X | Pediatric Critical Care Doctor | 036-095275 | IL |
N | 2080P0203X | Pediatric Critical Care Doctor | 32201 | AZ |
Y | 2080P0203X | Pediatric Critical Care Doctor | L0978 | TX |
NPI | 1033182977 |
---|---|
Provider Name | Dr. Sandra R Aviles |
First Address | Houston, TX 77210-4346 |
Second Address | San Antonio, TX 78258-3913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 19/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036095275 | (05) | IL |
832164 | (05) | AZ |
832164-06 | (05) | AZ |
F93589 | (02) | AZ |