Provider Demographics
NPI:1619967882
Name:MAKSYMOWSKI, AARON (LSA,CST/CFA, OPAC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MAKSYMOWSKI
Suffix:
Gender:M
Credentials:LSA,CST/CFA, OPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4509
Mailing Address - Country:US
Mailing Address - Phone:713-799-2300
Mailing Address - Fax:713-794-3395
Practice Address - Street 1:10223 BROADWAY ST STE A
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:713-436-3488
Practice Address - Fax:713-436-3860
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00081246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant