Individual
MARIO LEE AGUAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3601 4TH ST, 1B350K, LUBBOCK, TX 79430-0002
(806) 743-2981
(806) 743-2984
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-3492
(806) 743-3576
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686698
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
686698
TX
Other
Enumeration date
10/09/2012
Last updated
05/17/2017
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