Individual
DR. SANDRA R AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 MADISON OAK DR, SAN ANTONIO, TX 78258-3913
(210) 297-9640
(210) 297-9640
Mailing address
PO BOX 4346, HOUSTON, TX 77210-4346
(210) 558-6288
(210) 558-6289
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
32201
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
036-095275
IL
2080P0203X
Pediatric Critical Care Medicine Physician
32201
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
L0978
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095275
—
IL
05
—
832164
—
AZ
05
—
832164-06
—
AZ
Enumeration date
02/10/2006
Last updated
05/19/2015
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