Provider Demographics
NPI:1447019658
Name:DE LA CRUZ, AARON DANIEL
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:DANIEL
Last Name:DE LA CRUZ
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 1:4499 MEDICAL DR STE 171
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3789
Mailing Address - Country:US
Mailing Address - Phone:346-550-6457
Mailing Address - Fax:
Practice Address - Street 1:4499 MEDICAL DR STE 171
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3789
Practice Address - Country:US
Practice Address - Phone:346-550-6457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program