Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | 49904 | MN |
Y | 2086S0122X | Plastic and Reconstructive Surgery | M7813 | TX |
NPI | 1184821084 |
---|---|
Provider Name | Francisco J Agullo |
First Address | El Paso, TX 79925-7618 |
Second Address | El Paso, TX 79925-7618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 01/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270085000 | (05) | MN |