Provider Demographics
NPI:1174072797
Name:AGUIRRE, SANTOS JAVIER (FNP)
Entity type:Individual
Prefix:
First Name:SANTOS
Middle Name:JAVIER
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10720 N LOOP DR
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-4409
Mailing Address - Country:US
Mailing Address - Phone:915-858-0500
Mailing Address - Fax:
Practice Address - Street 1:10720 N LOOP DR
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-4409
Practice Address - Country:US
Practice Address - Phone:915-858-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX772597163W00000X
TX1003371363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse