Provider Demographics
NPI:1235740317
Name:OAFERINA, ALETH MURILLO
Entity Type:Individual
Prefix:
First Name:ALETH
Middle Name:MURILLO
Last Name:OAFERINA
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 1:230 MIDDLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-7743
Mailing Address - Country:US
Mailing Address - Phone:956-251-1002
Mailing Address - Fax:
Practice Address - Street 1:414 SHILOH DR UNIT 9
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6745
Practice Address - Country:US
Practice Address - Phone:956-791-8235
Practice Address - Fax:956-791-8239
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2155564225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant