MEDICARE: MRS. KELLY RENEE AGUILAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	M8474	TX
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	M8474	TX

General Provider Information

NPI Number	:	1932316395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY RENEE AGUILAR M.D.

Provider Business Mailing Address
First Line	:	2255 E MOSSY OAKS RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-1768
Country	:	US
Telephone Number	:	936-266-2190
Fax Number	:	936-266-8580

Provider Business Practice Location Address
First Line	:	2255 E MOSSY OAKS RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-1768
Country	:	US
Telephone Number	:	936-266-2190
Fax Number	:	936-266-8580

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	10/10/2024

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