Provider Demographics
NPI:1093359986
Name:AGUINAGA, DANTE (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:DANTE
Middle Name:
Last Name:AGUINAGA
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12146 LUCKEY SMT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-2327
Mailing Address - Country:US
Mailing Address - Phone:210-304-9269
Mailing Address - Fax:
Practice Address - Street 1:12146 LUCKEY SMT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78252-2327
Practice Address - Country:US
Practice Address - Phone:210-304-9269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113751235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist