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General NPI Number Information
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NPI Number | 1184131021
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Entity Type | Individual
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Provider Name | RODEL CELSO AGUIRRE AGACNP-BC, CCRN-CMC
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Gender | Male
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Dates
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Enumeration Date | 12/31/2017
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 5200 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75235-7709
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Country | US
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Telephone | 214-590-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2307 TAWNY OWL RD
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-2203
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Country | US
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Telephone | 240-646-2732
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP136127
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License Number State | TX
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