Provider Demographics
NPI:1780355461
Name:AGUILERA GARCIA, LUIS ARTURO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ARTURO
Last Name:AGUILERA GARCIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14333 PRESTON RD APT 1004
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-6500
Mailing Address - Country:US
Mailing Address - Phone:469-995-0373
Mailing Address - Fax:
Practice Address - Street 1:8900 TEHAMA RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-2004
Practice Address - Country:US
Practice Address - Phone:817-806-9843
Practice Address - Fax:817-806-9834
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69418183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX69418OtherLICENSED PHARMACIST