Provider Demographics
NPI:1922080118
Name:AGUAYO, ALFREDO (DC)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:
Last Name:AGUAYO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 NORTH ZARAGOZA
Mailing Address - Street 2:SUITE O
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907
Mailing Address - Country:US
Mailing Address - Phone:915-860-2233
Mailing Address - Fax:915-860-2233
Practice Address - Street 1:1030 NORTH ZARAGOZA
Practice Address - Street 2:SUITE O
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907
Practice Address - Country:US
Practice Address - Phone:915-860-2233
Practice Address - Fax:915-860-2233
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC7820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor