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General NPI Number Information
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NPI Number | 1144320243
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Entity Type | Organization
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Legal Business Name | AGUAYO CHIROPRACTIC PC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 61 CAMILLE DR.
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City | EL PASO
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State | TX
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Zip | 79912
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Country | US
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Telephone | 915-581-9619
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Fax | 915-581-9629
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Provider Business Mailing Address
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Address Line | PO BOX 220336
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City | EL PASO
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State | TX
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Zip | 79913-2336
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Country | US
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Telephone | 915-581-9619
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Fax | 915-581-9629
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC, OWNER
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Name | DR. FRED AGUAYO
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Credential | D.C.
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Telephone | 915-581-9619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7820
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License Number State | TX
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