Provider Demographics
NPI:1043676133
Name:AGUIRRE, ELOY
Entity Type:Individual
Prefix:
First Name:ELOY
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 SHARM DR
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7444
Mailing Address - Country:US
Mailing Address - Phone:956-783-3569
Mailing Address - Fax:956-783-3568
Practice Address - Street 1:1817 SHARM DR
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7444
Practice Address - Country:US
Practice Address - Phone:956-783-3569
Practice Address - Fax:956-783-3568
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
No171W00000XOther Service ProvidersContractor