Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 35451 | OK |
N | 2086S0122X | Plastic and Reconstructive Surgery | F2138 | TX |
NPI | 1043315542 |
---|---|
Provider Name | Jacinto Zambrano JR. |
First Address | Norman, OK 73072-9738 |
Second Address | Norman, OK 73072-9738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 27/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
127511707 | (05) | TX |