Provider Demographics
NPI:1649454315
Name:AGUILAR, CHRISTINE M (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 S MASON RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5205 S MASON RD
Practice Address - Street 2:SUITE 160
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7138
Practice Address - Country:US
Practice Address - Phone:832-382-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6521T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172265401Medicaid
V04411Medicare UPIN
TX172265401Medicaid