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General NPI Number Information
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NPI Number | 1811078579
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Entity Type | Organization
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Legal Business Name | MARIO R. AGUILAR, M.D.,P.C.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 1240 S TELSHOR BLVD SUITE C
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City | LAS CRUCES
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State | NM
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Zip | 88011-4731
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Country | US
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Telephone | 575-522-1212
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Fax | 575-522-2898
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Provider Business Mailing Address
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Address Line | 1240 S TELSHOR BLVD SUITE C
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City | LAS CRUCES
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State | NM
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Zip | 88011-4731
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Country | US
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Telephone | 575-522-1212
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Fax | 575-522-2898
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIO R. AGUILAR
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Credential | M.D.
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Telephone | 575-522-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 85-2
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License Number State | NM
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