Provider Demographics
NPI:1699925560
Name:ALMA L. AGUADO, M.D., P.A.
Entity type:Organization
Organization Name:ALMA L. AGUADO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:L
Authorized Official - Last Name:AGUADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-924-6649
Mailing Address - Street 1:600 DIVISION AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-1350
Mailing Address - Country:US
Mailing Address - Phone:210-924-6649
Mailing Address - Fax:210-924-0198
Practice Address - Street 1:600 DIVISION AVE
Practice Address - Street 2:SUITE G
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-1350
Practice Address - Country:US
Practice Address - Phone:210-924-6649
Practice Address - Fax:210-924-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092449001Medicaid
TX092449001Medicaid
TX00Z644Medicare PIN