Provider Demographics
NPI:1629874227
Name:AGUILAR, ABRAHAM (OTD)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 LA PUERTA AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-4397
Mailing Address - Country:US
Mailing Address - Phone:956-451-2676
Mailing Address - Fax:
Practice Address - Street 1:3225 LA PUERTA AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-4397
Practice Address - Country:US
Practice Address - Phone:956-451-2676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114039225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist