Provider Demographics
NPI:1215074679
Name:AGUILAR, NICOLAS (PA-C)
Entity type:Individual
Prefix:MR
First Name:NICOLAS
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8328 RED ROSE TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8420
Mailing Address - Country:US
Mailing Address - Phone:405-388-3340
Mailing Address - Fax:
Practice Address - Street 1:801 W PARK ROW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3904
Practice Address - Country:US
Practice Address - Phone:817-303-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant