Provider Demographics
NPI:1346687787
Name:AGUIRRE, HEATHER GUADALUPE (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:GUADALUPE
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E AMBER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-2456
Mailing Address - Country:US
Mailing Address - Phone:956-518-9414
Mailing Address - Fax:
Practice Address - Street 1:18626 HARDY OAK BLVD #210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-5387
Practice Address - Country:US
Practice Address - Phone:210-392-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2720207Q00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX473006YLPSOtherWMG PTAN