Basic Information
| Provider Information | |||||||||
| NPI: | 1467515403 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AGUILAR | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | EVELYN | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7703 FLOYD CURL DR # MC7977 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103584000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4502 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103584000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 619761 | TX | N | Nursing Service Providers | Registered Nurse | 163W00000X | 657298 | CA | N | Nursing Service Providers | Registered Nurse | 163WX0200X | 657298 | CA | N | Nursing Service Providers | Registered Nurse | Oncology | 163WX0200X | 619761 | TX | N | Nursing Service Providers | Registered Nurse | Oncology | 363L00000X | 16177 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 619761 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | AP114231 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 214983303 | 05 | TX | MEDICAID | 214983304 | 05 | TX | MEDICAID | 619761 | 01 | TX | FNP | OTHER | 16177 | 01 | CA | NURSE PRACTITIONER | OTHER | 214983305 | 01 | TX | CSHCN | OTHER | 657298 | 01 | CA | REGISTERED NURSE | OTHER |