Provider Demographics
NPI:1548703093
Name:SANDRA AGUILAR, PLLC
Entity type:Organization
Organization Name:SANDRA AGUILAR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:512-809-1018
Mailing Address - Street 1:2851 JOE DIMAGGIO BLVD STE 24
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3933
Mailing Address - Country:US
Mailing Address - Phone:512-809-1018
Mailing Address - Fax:512-238-1960
Practice Address - Street 1:2851 JOE DIMAGGIO BLVD STE 24
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3933
Practice Address - Country:US
Practice Address - Phone:512-809-1018
Practice Address - Fax:512-238-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70189101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty