Provider Demographics
NPI:1891037123
Name:DAVILA, MICHAEL AGUILAR (NP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:AGUILAR
Last Name:DAVILA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:A
Other - Last Name:DAVILA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP
Mailing Address - Street 1:1712 CHARDONNAY
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-1885
Mailing Address - Country:US
Mailing Address - Phone:210-473-7815
Mailing Address - Fax:210-473-7815
Practice Address - Street 1:1712 CHARDONNAY
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-1885
Practice Address - Country:US
Practice Address - Phone:210-473-7815
Practice Address - Fax:210-473-7815
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX608072261QP2300X, 363LG0600X
TXAP123452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology