Basic Information
| Provider Information | |||||||||
| NPI: | 1639348048 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANGUIANO | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1715 MCCULLOUGH AVE | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782124046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102255323 | ||||||||
| FaxNumber: | 2102257505 | ||||||||
| Practice Location | |||||||||
| Address1: | 1715 MCCULLOUGH AVE | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782124046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102255323 | ||||||||
| FaxNumber: | 2102257505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2008 | ||||||||
| LastUpdateDate: | 10/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | L2102 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1518797-02 | 01 | TX | WELLMED MEDICAID | OTHER | TXB127987 | 01 | WELLMED MEDICAL GROUP PA | OTHER |