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NPI Code Detail

MEDICARE: AURORA MEDICAL GROUP, LLC

MEDICARE: AURORA MEDICAL GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1194379438
Entity Type Code : Organization
Provider Name (Legal Business Name) : AURORA MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 17754 PRESTON RD STE 200
Second Line :
City : DALLAS
State : TX
Zip : 75252-5638
Country : US
Telephone Number : 972-934-7060
Fax Number :
Provider Business Practice Location Address
First Line : 17754 PRESTON RD STE 200
Second Line :
City : DALLAS
State : TX
Zip : 75252-5638
Country : US
Telephone Number : 972-934-7060
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. ZAUR GASANOV
Credential :
Telephone Number : 972-934-7060
Provider Enumeration Date : 07/25/2019
Last Update Date : 07/25/2019

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Directions to “AURORA MEDICAL GROUP, LLC ” Practice Location

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