Provider Demographics
NPI:1649600818
Name:HOMERO O AGUILAR,MD
Entity Type:Organization
Organization Name:HOMERO O AGUILAR,MD
Other - Org Name:SAN BENITO ADULT & GERIATRIC MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SAENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-423-0165
Mailing Address - Street 1:151 E US HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-5232
Mailing Address - Country:US
Mailing Address - Phone:956-361-4558
Mailing Address - Fax:956-361-4998
Practice Address - Street 1:151 E US HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-5232
Practice Address - Country:US
Practice Address - Phone:956-361-4558
Practice Address - Fax:956-361-4998
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMERO O AGUILR,MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty