Provider Demographics
NPI:1932438173
Name:CARRILLO, ALDO L (RPA/RA)
Entity Type:Individual
Prefix:MR
First Name:ALDO
Middle Name:L
Last Name:CARRILLO
Suffix:
Gender:M
Credentials:RPA/RA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11692 PRIVADA CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4070
Mailing Address - Country:US
Mailing Address - Phone:915-857-2337
Mailing Address - Fax:915-857-2337
Practice Address - Street 1:11692 PRIVADA CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4070
Practice Address - Country:US
Practice Address - Phone:915-857-2337
Practice Address - Fax:915-857-2337
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY08 TX 1345243U00000X
WY08TX1345363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant