Provider Demographics
NPI:1265154405
Name:AGUILLON, DANIZA ESMERALDA (MSN, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:DANIZA
Middle Name:ESMERALDA
Last Name:AGUILLON
Suffix:
Gender:F
Credentials:MSN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 S VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4348
Mailing Address - Country:US
Mailing Address - Phone:972-607-5342
Mailing Address - Fax:
Practice Address - Street 1:221 W COLORADO BLVD STE 525
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2312
Practice Address - Country:US
Practice Address - Phone:214-956-4525
Practice Address - Fax:214-960-5681
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1093964363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care