Provider Demographics
NPI:1952980690
Name:AGUAYO, ANA CRISTINA (PA)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CRISTINA
Last Name:AGUAYO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 VICTORIA LN STE 2
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3227
Mailing Address - Country:US
Mailing Address - Phone:956-365-4400
Mailing Address - Fax:956-365-4111
Practice Address - Street 1:512 VICTORIA LN STE 2
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3227
Practice Address - Country:US
Practice Address - Phone:956-365-4400
Practice Address - Fax:956-365-4111
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208439006OtherORGANIZATION TAX ID