Provider Demographics
NPI:1154901122
Name:ARRIAGA, AARON ROBLES
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:ROBLES
Last Name:ARRIAGA
Suffix:
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 1:501 JUNE ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-1650
Mailing Address - Country:US
Mailing Address - Phone:979-446-6783
Mailing Address - Fax:
Practice Address - Street 1:1609 N TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-1828
Practice Address - Country:US
Practice Address - Phone:979-778-2074
Practice Address - Fax:979-778-3783
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206208183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206208OtherTEXAS STATE BOARD OF PHARMACY