Provider Demographics
NPI:1487949103
Name:NIEVES, GILBERTO AARON JR (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:AARON
Last Name:NIEVES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARL R DARNALL ARMY MEDICAL CENTER
Mailing Address - Street 2:590 MEDICAL CENTER ROAD, BLDG 36065
Mailing Address - City:FORT CAVAZOS
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-288-8000
Mailing Address - Fax:
Practice Address - Street 1:CARL R DARNALL ARMY MEDICAL CENTER
Practice Address - Street 2:590 MEDICAL CENTER ROAD, BLDG 36065
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-02491208D00000X
HI16846208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000OtherUPIN