Provider Demographics
NPI:1639505084
Name:IBARRA, AROLDO JOSE JR (PA)
Entity Type:Individual
Prefix:MR
First Name:AROLDO
Middle Name:JOSE
Last Name:IBARRA
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:177 KIRKHAM CIR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-9703
Mailing Address - Country:US
Mailing Address - Phone:512-617-1752
Mailing Address - Fax:512-788-5819
Practice Address - Street 1:177 KIRKHAM CIR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-9703
Practice Address - Country:US
Practice Address - Phone:512-617-1752
Practice Address - Fax:512-788-5819
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2023-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08448363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant