Provider Demographics
NPI:1679515019
Name:GILBERT AIDINIAN, MD PA
Entity type:Organization
Organization Name:GILBERT AIDINIAN, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-974-5232
Mailing Address - Street 1:1300 MURCHISON DR
Mailing Address - Street 2:STE. 110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4842
Mailing Address - Country:US
Mailing Address - Phone:915-577-0121
Mailing Address - Fax:915-577-9444
Practice Address - Street 1:1300 MURCHISON DR
Practice Address - Street 2:STE. 110
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4842
Practice Address - Country:US
Practice Address - Phone:915-577-0121
Practice Address - Fax:915-577-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0087NJOtherBCBS OF TEXAS
TX0087NJOtherBCBS OF TEXAS