Provider Demographics
NPI:1982734703
Name:AGUILAR, LYDIA (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N 19TH ST
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2344
Mailing Address - Country:US
Mailing Address - Phone:325-670-5565
Mailing Address - Fax:325-670-5568
Practice Address - Street 1:1100 N 19TH ST
Practice Address - Street 2:SUITE 4A
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2344
Practice Address - Country:US
Practice Address - Phone:325-670-5565
Practice Address - Fax:325-670-5568
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8835B7Medicare ID - Type Unspecified
TXH65706Medicare UPIN