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Individual

HUMBERTO I AGUILAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8383 MILLICENT WAY STE B, SHREVEPORT, LA 71115-5207
(318) 631-9121
(318) 213-6246
Mailing address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
11575R
LA
207RT0003X
Transplant Hepatology Physician
11575R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1684929
LA
01
MD.11575R
STATE LICENSE
LA
Enumeration date
10/27/2005
Last updated
08/12/2022
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