Provider Demographics
NPI:1194906313
Name:MARK AGUILAR M.D., P.A.
Entity type:Organization
Organization Name:MARK AGUILAR M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-480-8884
Mailing Address - Street 1:13920 OSPREY CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4374
Mailing Address - Country:US
Mailing Address - Phone:281-480-8884
Mailing Address - Fax:281-480-8585
Practice Address - Street 1:13920 OSPREY CT
Practice Address - Street 2:SUITE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4374
Practice Address - Country:US
Practice Address - Phone:281-480-8884
Practice Address - Fax:281-480-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026JUOtherBCBS
TX00920UMedicare PIN
TX0026JUOtherBCBS