Healthcare Provider Details

I. General information

NPI: 1104886555
Provider Name (Legal Business Name): MICHAEL A ARAGON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 HAWKINS VIEW DR SUITE 410
FORT WORTH TX
76132-3920
US

IV. Provider business mailing address

3801 WILLIAM D TATE AVE STE 105
GRAPEVINE TX
76051-8755
US

V. Phone/Fax

Practice location:
  • Phone: 817-294-0280
  • Fax: 817-294-2084
Mailing address:
  • Phone: 817-488-6812
  • Fax: 817-251-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberL4856
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: