Provider Demographics
NPI:1598042079
Name:PACK, AARON E (NP)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:E
Last Name:PACK
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:8117 PRESTON RD
Mailing Address - Street 2:STE 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6332
Mailing Address - Country:US
Mailing Address - Phone:214-666-9608
Mailing Address - Fax:214-764-5754
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:12TH FLOOR / APOGEE
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-961-6995
Practice Address - Fax:716-898-5193
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2022-09-19
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Provider Licenses
StateLicense IDTaxonomies
TX753964363LA2100X
NY430909363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB147237Medicaid
TXTXB147237Medicaid