Provider Demographics
NPI:1497473623
Name:MONCEVAIS, AARON (MS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MONCEVAIS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 PENNBRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-5915
Mailing Address - Country:US
Mailing Address - Phone:832-943-4035
Mailing Address - Fax:
Practice Address - Street 1:225 PENNBRIGHT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-5915
Practice Address - Country:US
Practice Address - Phone:832-943-4035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373188702Medicaid