Provider Demographics
NPI:1043279631
Name:AGUILAR, ROBERT G (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:3312 LONGMIRE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5812
Mailing Address - Country:US
Mailing Address - Phone:979-776-6060
Mailing Address - Fax:979-776-6172
Practice Address - Street 1:637 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5412
Practice Address - Country:US
Practice Address - Phone:979-836-2992
Practice Address - Fax:979-776-6172
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1532213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080873501Medicaid
TXP00367018OtherRAIL ROAD MEDICARE
TX8W6360OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX8W6360OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX00613KMedicare Oscar/Certification
TX0314130001Medicare NSC
TXP00367018OtherRAIL ROAD MEDICARE