Provider Demographics
NPI:1861761926
Name:ARRIAGA, JOSE A
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:ARRIAGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W HILLSIDE RD
Mailing Address - Street 2:STE 15
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3196
Mailing Address - Country:US
Mailing Address - Phone:956-796-1166
Mailing Address - Fax:
Practice Address - Street 1:201 W HILLSIDE RD
Practice Address - Street 2:STE 15
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3196
Practice Address - Country:US
Practice Address - Phone:956-796-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZAIGA2103156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician