Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1762 | TX |
Y | 222Z00000X | Podiatrist | 1762 | TX |
NPI | 1003822750 |
---|---|
Provider Name | Thomas Zgonis |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 30/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
174736203 | (05) | TX |