MEDICARE: DR. JOSE CARLOS AGUILAR D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9752	TX

General Provider Information

NPI Number	:	1558385443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE CARLOS AGUILAR D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 925397
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77292-5397
Country	:	US
Telephone Number	:	713-688-3941
Fax Number	:	713-688-1115

Provider Business Practice Location Address
First Line	:	5009 ANTOINE DR
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77092-3358
Country	:	US
Telephone Number	:	713-688-3941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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