Provider Demographics
NPI:1962471540
Name:AGUILAR, HOMERO O (MD)
Entity Type:Individual
Prefix:
First Name:HOMERO
Middle Name:O
Last Name:AGUILAR
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 1:321 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7152
Mailing Address - Country:US
Mailing Address - Phone:956-423-0165
Mailing Address - Fax:956-423-2494
Practice Address - Street 1:321 S 13TH ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7152
Practice Address - Country:US
Practice Address - Phone:956-423-0165
Practice Address - Fax:956-423-2494
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE-6204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031900601Medicaid
TX031900601Medicaid
TXC12627Medicare UPIN