Healthcare Provider Details

I. General information

NPI: 1487194502
Provider Name (Legal Business Name): ARAGON MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9203 SKILLMAN ST SUITE 126
DALLAS TX
75243-9032
US

IV. Provider business mailing address

2529 E LANCASTER AVE SUITE A
FORT WORTH TX
76103-2253
US

V. Phone/Fax

Practice location:
  • Phone: 817-907-6714
  • Fax:
Mailing address:
  • Phone: 817-907-6714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA L. ROBERTS, HARRIS
Title or Position: ADMINISTRATOR
Credential: D. O.
Phone: 817-907-6714