Provider Demographics
NPI:1144906157
Name:ANDERSON, AARIES D (NCPT)
Entity type:Individual
Prefix:
First Name:AARIES
Middle Name:D
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 CHASE OAKS BLVD APT 121
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5909
Mailing Address - Country:US
Mailing Address - Phone:901-335-7181
Mailing Address - Fax:972-666-0104
Practice Address - Street 1:7101 CHASE OAKS BLVD APT 121
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5909
Practice Address - Country:US
Practice Address - Phone:901-335-7181
Practice Address - Fax:972-666-0104
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN987193246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy