Provider Demographics
NPI:1639176340
Name:AGUILAR, NICK SALVADOR (MD)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:SALVADOR
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3303 ROGERS ROAD, SUITE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3650
Mailing Address - Country:US
Mailing Address - Phone:210-520-2224
Mailing Address - Fax:210-520-2238
Practice Address - Street 1:3303 ROGERS ROAD, SUITE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3650
Practice Address - Country:US
Practice Address - Phone:210-520-2224
Practice Address - Fax:210-520-2238
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BB290OtherBCBSTX
TX8BB290OtherBCBSTX
TX8F7838Medicare PIN