Provider Demographics
NPI:1689562191
Name:FALAVOLITO, AIMEE
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:FALAVOLITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 W CHELSEA PL
Mailing Address - Street 2:
Mailing Address - City:EL LAGO
Mailing Address - State:TX
Mailing Address - Zip Code:77586-5822
Mailing Address - Country:US
Mailing Address - Phone:832-425-1152
Mailing Address - Fax:
Practice Address - Street 1:1631 W CHELSEA PL
Practice Address - Street 2:
Practice Address - City:EL LAGO
Practice Address - State:TX
Practice Address - Zip Code:77586-5822
Practice Address - Country:US
Practice Address - Phone:832-425-1152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist