Provider Demographics
NPI:1396022653
Name:AGUILAR, MELISSA (DPT-LPT)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:DPT-LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E BELL AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3927
Mailing Address - Country:US
Mailing Address - Phone:956-467-2461
Mailing Address - Fax:956-783-7109
Practice Address - Street 1:6422 S CAGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6957
Practice Address - Country:US
Practice Address - Phone:956-783-7111
Practice Address - Fax:956-783-7109
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1212013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist