Provider Demographics
NPI:1558801126
Name:AGUILERA, AGUSTIN DANIEL (ATP)
Entity Type:Individual
Prefix:
First Name:AGUSTIN
Middle Name:DANIEL
Last Name:AGUILERA
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 KIRBY DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2533
Mailing Address - Country:US
Mailing Address - Phone:713-791-1011
Mailing Address - Fax:
Practice Address - Street 1:9220 KIRBY DR
Practice Address - Street 2:SUITE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2533
Practice Address - Country:US
Practice Address - Phone:713-791-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other