Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G0320 | TX |
NPI | 1023038155 |
---|---|
Provider Name | John J Zavaleta |
First Address | Irving, TX 75062-3636 |
Second Address | Irving, TX 75062-3636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B27801 | (02) | TX |