Provider Demographics
NPI:1104786136
Name:SANTOS AGUILA, HETIAN SR
Entity type:Individual
Prefix:
First Name:HETIAN
Middle Name:
Last Name:SANTOS AGUILA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6464 E SAM HOUSTON PKWY N APT 124
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-7251
Mailing Address - Country:US
Mailing Address - Phone:305-748-7355
Mailing Address - Fax:
Practice Address - Street 1:6464 E SAM HOUSTON PKWY N APT 124
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-7251
Practice Address - Country:US
Practice Address - Phone:305-748-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty