Provider Demographics
NPI:1467413567
Name:AGGARWAL, AJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:
Last Name:AGGARWAL
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 1:600 HOSPITAL CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4772
Mailing Address - Country:US
Mailing Address - Phone:979-245-7246
Mailing Address - Fax:979-245-2415
Practice Address - Street 1:600 HOSPITAL CIR STE 200
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-4772
Practice Address - Country:US
Practice Address - Phone:979-245-7246
Practice Address - Fax:979-245-2415
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7879207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029550301Medicaid
TXG15694Medicare UPIN
TX0008ACMedicare PIN