Provider Demographics
NPI:1225218845
Name:CESSNA, AARON C (DO)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:C
Last Name:CESSNA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:2528 JACKSBORO HWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-2206
Practice Address - Country:US
Practice Address - Phone:817-624-1770
Practice Address - Fax:817-625-1287
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9202208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195086701Medicaid
TX195086702Medicaid
TX140442863Medicaid
TX140442852Medicaid
TX137345810Medicaid
TX140442863Medicaid
TX195086701Medicaid