Provider Demographics
NPI:1982905766
Name:EDUARDO J. AGUEROS M.D. PA.
Entity Type:Organization
Organization Name:EDUARDO J. AGUEROS M.D. PA.
Other - Org Name:CLINICA SIETE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HORACIO
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:AGUEROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-474-6836
Mailing Address - Street 1:2609 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3905
Mailing Address - Country:US
Mailing Address - Phone:512-474-6836
Mailing Address - Fax:512-474-1904
Practice Address - Street 1:2609 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3905
Practice Address - Country:US
Practice Address - Phone:512-474-6836
Practice Address - Fax:512-474-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6791261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00354GOtherMEDICARE
TX0301293-01Medicaid
TX00354GOtherMEDICARE