Provider Demographics
NPI:1306803465
Name:AGUINALDO, ALLEN GONZAGA (CST)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:GONZAGA
Last Name:AGUINALDO
Suffix:
Gender:M
Credentials:CST
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6770
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6770
Mailing Address - Country:US
Mailing Address - Phone:361-883-2000
Mailing Address - Fax:361-883-0573
Practice Address - Street 1:6118 PARKWAY
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2455
Practice Address - Country:US
Practice Address - Phone:361-883-2000
Practice Address - Fax:361-883-0573
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX102257 CERTIFICATE246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist