Doctor Name: | MR. GUADALUPE AGUILAR |
NPI Number: | 1780953174 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 333 W Brown Deer Rd Fox Point, WI - 532172372 |
Business Phone Number: | 4142289873 |
Business Fax Number: | 4142289841 |
Mailing Address: | 333 W Brown Deer Rd, FOX POINT |
State: | WI |
Postal Code: | 532172372 |
Phone Number: | 4142289873 |
Fax Number: | 4142289841 |
NPI Enumeration Date: | 12/14/2011 |
NPI Last Update Date: | 12/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |