Healthcare Provider Details

I. General information

NPI: 1427811488
Provider Name (Legal Business Name): JONATHAN LEX URANGA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 WALNUT HILL LN STE 320
DALLAS TX
75231-4481
US

IV. Provider business mailing address

8230 WALNUT HILL LN STE 320
DALLAS TX
75231-4481
US

V. Phone/Fax

Practice location:
  • Phone: 214-369-5432
  • Fax: 214-369-5591
Mailing address:
  • Phone: 214-369-5432
  • Fax: 214-369-5591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA18244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: