Provider Demographics
NPI:1407591357
Name:AGUILAR, LAUREN MARIE (OD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 STECK AVE STE A121
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8786
Mailing Address - Country:US
Mailing Address - Phone:512-328-0555
Mailing Address - Fax:512-340-0009
Practice Address - Street 1:3921 STECK AVE STE A121
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-328-0555
Practice Address - Fax:512-340-0009
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022045068152W00000X
TX10965T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist