Provider Demographics
NPI:1821236472
Name:AGUILAR, BILLY JACK (NP)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:JACK
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:861 SW 78TH AVE
Mailing Address - Street 2:# 100-B
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3273
Mailing Address - Country:US
Mailing Address - Phone:877-693-0000
Mailing Address - Fax:954-625-6034
Practice Address - Street 1:520 E 6TH ST
Practice Address - Street 2:EMEGENCY DEPARTMENT
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4527
Practice Address - Country:US
Practice Address - Phone:877-693-0000
Practice Address - Fax:954-625-6034
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX667109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner