Provider Demographics
NPI:1700829736
Name:AGUIRRE, DAVID (MED, LPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 E YANDELL DR
Mailing Address - Street 2:EL PASO CHILD GUIDANCE CENTER
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903
Mailing Address - Country:US
Mailing Address - Phone:915-562-1999
Mailing Address - Fax:915-562-1993
Practice Address - Street 1:2701 E YANDELL DR
Practice Address - Street 2:EL PASO CHILD GUIDANCE CENTER
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3726
Practice Address - Country:US
Practice Address - Phone:915-562-1999
Practice Address - Fax:915-562-1993
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3458101YM0800X
TX11287101YP2500X
TX4071106H00000X
NM54628101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80964LOtherBCBS