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General NPI Number Information
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NPI Number | 1003644188
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Entity Type | Individual
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Provider Name | DEANNA AGUILAR
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 5702 S STAPLES ST # F-2C
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-3784
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Country | US
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Telephone | 361-510-7616
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Fax | 361-500-4018
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Provider Business Mailing Address
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Address Line | 5702 S STAPLES ST # F-2C
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-3784
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Country | US
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Telephone | 361-510-7616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT030360
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License Number State | TX
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