MEDICARE: MS. LAUREN ASHLEY ZAUCHA PA-C

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
1	363A00000X	Physician Assistant	085007332	IL
2	363A00000X	Physician Assistant	PA14668	TX

General Provider Information

NPI Number	:	1568003655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREN ASHLEY ZAUCHA PA-C

Provider Business Mailing Address
First Line	:	3131 TURTLE CREEK BLVD STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-5435
Country	:	US
Telephone Number	:	972-400-2866
Fax Number	:

Provider Business Practice Location Address
First Line	:	3131 TURTLE CREEK BLVD STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-5435
Country	:	US
Telephone Number	:	972-400-2866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2019
Last Update Date	:	08/11/2023

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