Provider Demographics
NPI:1265020135
Name:ARAGON, ANTONIO (CPHRT)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:ARAGON
Suffix:
Gender:M
Credentials:CPHRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 EUBANK BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-1300
Mailing Address - Country:US
Mailing Address - Phone:505-294-1597
Mailing Address - Fax:505-275-0340
Practice Address - Street 1:2801 EUBANK BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1300
Practice Address - Country:US
Practice Address - Phone:505-294-1597
Practice Address - Fax:505-275-0340
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
602817OtherNABP
260101030753849OtherPTCB