Healthcare Provider Details
I. General information
NPI: 1477651719
Provider Name (Legal Business Name): OSCAR ANTONIO AGUIRRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/20/2006
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11953 LIONESS WAY SUITE 101
PARKER CO
80134-5640
US
IV. Provider business mailing address
11953 LIONESS WAY SUITE 101
PARKER CO
80134-5640
US
V. Phone/Fax
- Phone: 303-322-0500
- Fax: 303-322-0772
- Phone: 303-322-0500
- Fax: 303-322-0772
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 36046 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | 970434 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: