Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2033470 | TX |
Y | 213ES0000X | Sports Medicine | 2033470 | TX |
NPI | 1346912243 |
---|---|
Provider Name | Yolanda Maliwanag Aquino |
First Address | Houston, TX 77080-7617 |
Second Address | Houston, TX 77024-1287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2021 |
Last Update Date | 29/09/2021 |