Provider Demographics
NPI:1679829188
Name:ALBERTO AGUAYO MD, PA
Entity Type:Organization
Organization Name:ALBERTO AGUAYO MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUAYO OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-639-5072
Mailing Address - Street 1:5636 SOUTHMOST RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-6389
Mailing Address - Country:US
Mailing Address - Phone:956-621-0477
Mailing Address - Fax:
Practice Address - Street 1:5636 SOUTHMOST RD
Practice Address - Street 2:SUITE A
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-6389
Practice Address - Country:US
Practice Address - Phone:956-621-0477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1973207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285727801Medicaid