Healthcare Provider Details

I. General information

NPI: 1205710159
Provider Name (Legal Business Name): AURUM BEAUTY COSMETIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2091 SUMMER LEE DR STE 101
ROCKWALL TX
75032-5531
US

IV. Provider business mailing address

2091 SUMMER LEE DR STE 101
ROCKWALL TX
75032-5531
US

V. Phone/Fax

Practice location:
  • Phone: 469-887-1508
  • Fax: 469-242-9824
Mailing address:
  • Phone: 469-887-1508
  • Fax: 469-242-9824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. HILLARY M JACKSON
Title or Position: OWNER
Credential: MD
Phone: 214-893-1255