Healthcare Provider Details
I. General information
NPI: 1326535410
Provider Name (Legal Business Name): HEALING HANDS OF NEBRASKA, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2018
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2122 N 117TH AVE
OMAHA NE
68164-3670
US
IV. Provider business mailing address
PO BOX 7
BOYS TOWN NE
68010-0007
US
V. Phone/Fax
- Phone: 402-970-9515
- Fax: 402-227-8245
- Phone: 402-370-9515
- Fax: 402-227-8245
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 27722 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | 27722 |
| License Number State | NE |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP3300X |
| Taxonomy | Pain Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEMETRIO
JUAN
AGUILA
III
Title or Position: SURGEON
Credential: MD
Phone: 402-370-9515