Provider Demographics
NPI:1346348471
Name:ANGUIANO, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ANGUIANO
Suffix:
Gender:M
Credentials:MD
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 1668
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-1668
Mailing Address - Country:US
Mailing Address - Phone:956-333-3008
Mailing Address - Fax:210-314-4949
Practice Address - Street 1:1310 JUNCTION DR STE A
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6512
Practice Address - Country:US
Practice Address - Phone:956-333-3008
Practice Address - Fax:210-314-4949
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK24022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036530602Medicaid
TX036530604Medicaid
TXG44981Medicare UPIN
TX036530602Medicaid