Provider Demographics
NPI:1366453326
Name:AGUILAR, MARLA ELAINE (PT)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:ELAINE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16334 PEACH ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3954
Mailing Address - Country:US
Mailing Address - Phone:832-512-4371
Mailing Address - Fax:
Practice Address - Street 1:9810 FM 1960 BYPASS RD W STE 190
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3522
Practice Address - Country:US
Practice Address - Phone:281-446-0371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86482TOtherBCBS