Physician Compare National (NPI:1275846156)

HEALTHCARE PROVIDER: MARIO LUIS VASQUEZ AGUILAR

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1275846156
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375723893
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110215000712
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VASQUEZ AGUILAR
	Individual professional last name
Provider First Name	MARIO
	Individual professional first name
Provider Middle Name	LUIS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	FAMILY HEALTH CENTER LLP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3476522012
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2768 PHARMACY RD
	Group Practice or individual's line 1 address
City	RIO GRANDE CITY
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	785826201
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9564875621
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450869
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DOCTORS HOSPITAL AT RENAISSANCE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450654
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	STARR COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y