Provider Demographics
NPI:1881671808
Name:AQUINO, BRIAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:AQUINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 HIGHWAY 3 S
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3755
Mailing Address - Country:US
Mailing Address - Phone:281-332-6573
Mailing Address - Fax:281-332-7409
Practice Address - Street 1:302 HIGHWAY 3 S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3755
Practice Address - Country:US
Practice Address - Phone:281-332-6573
Practice Address - Fax:281-332-7409
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136765402Medicaid
TXA03428Medicare UPIN
TX88V592Medicare ID - Type Unspecified