MEDICARE: ARAUCO MEDICAL CONSULTANTS

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	305S00000X	Point of Service

General Provider Information

NPI Number	:	1891269890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARAUCO MEDICAL CONSULTANTS

Provider Business Mailing Address
First Line	:	400 N SAINT PAUL ST STE 1200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-6869
Country	:	US
Telephone Number	:	214-256-4076
Fax Number	:	214-256-4066

Provider Business Practice Location Address
First Line	:	400 N SAINT PAUL ST STE 1200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-6869
Country	:	US
Telephone Number	:	214-256-4076
Fax Number	:	214-256-4066

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JESUS SAMUEL ARAUCO JR.
Credential	:
Telephone Number	:	214-587-3661

Provider Enumeration Date	:	01/14/2019
Last Update Date	:	01/14/2019

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