Healthcare Provider Details

I. General information

NPI: 1659089787
Provider Name (Legal Business Name): BAILEY AURORA QUINN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BAILEY AURORA CAROTHERS

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16545 SOUTHWEST FWY STE 150
SUGAR LAND TX
77479-3600
US

IV. Provider business mailing address

14 GRANTS LAKE CIR
SUGAR LAND TX
77479-1382
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-1400
  • Fax: 281-207-2200
Mailing address:
  • Phone: 805-844-0880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1105864
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: