=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265977631
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AARON C EUBANKS MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2016
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 261 W SOUTHLAKE BLVD
-----------------------------------------------------
City | SOUTHLAKE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76092-7046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-310-8783
-----------------------------------------------------
Fax | 817-431-0735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 261 W SOUTHLAKE BLVD
-----------------------------------------------------
City | SOUTHLAKE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76092-7046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-310-8783
-----------------------------------------------------
Fax | 855-640-3872
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AARON C EUBANKS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 817-310-8783
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | RO566
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------