Provider Demographics
NPI:1639621964
Name:AGUILAR RODRIGUEZ, WALTER D (SA-C)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:D
Last Name:AGUILAR RODRIGUEZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 CENTRE PKWY
Mailing Address - Street 2:SUITE 530
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8271
Mailing Address - Country:US
Mailing Address - Phone:713-777-4539
Mailing Address - Fax:713-583-2061
Practice Address - Street 1:9800 CENTRE PKWY
Practice Address - Street 2:SUITE 530
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8271
Practice Address - Country:US
Practice Address - Phone:713-777-4539
Practice Address - Fax:713-583-2061
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14-307246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant