Provider Demographics
NPI:1235113754
Name:OAFERINA, ALETH SIGUENZA (PT)
Entity Type:Individual
Prefix:MR
First Name:ALETH
Middle Name:SIGUENZA
Last Name:OAFERINA
Suffix:
Gender:M
Credentials:PT
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 451267
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0031
Mailing Address - Country:US
Mailing Address - Phone:956-791-8235
Mailing Address - Fax:956-791-8239
Practice Address - Street 1:414 SHILOH DR
Practice Address - Street 2:SUITE 9
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6744
Practice Address - Country:US
Practice Address - Phone:956-791-8235
Practice Address - Fax:956-791-8239
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX087749003Medicaid
TX7077083OtherAETNA PROVIDER NO.
TX659552OtherBLUE CROSS BLUE SHIELD
TXTXB103805OtherMEDICARE NUMBER
TX742820153OtherFORTIS
TX8C6088OtherPTAN
TX742820153OtherPHCS NO.
TX8T4077OtherBCBS PROVIDER NO.
TX0081899OtherBCBS BLUE LINK NO.
TX087749001Medicaid
TX742673401OAFOtherMERCY HEALTH PLANS
TXLRD008OtherTML PROVIDER NO.
TX087749002Medicaid
TX7992711OtherAETNA PIN
TX7992711OtherAETNA PIN