Organization Name: | ZAPATA MEDICAL CLINIC |
NPI Number: | 1093982290 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN D. FORD (PRESIDENT) |
Mailing Address: | 316 N Henderson Blvd Ste A Kilgore |
State: | TX US |
Postal Code: | 756622712 |
Phone Number: | 9039842145 |
Fax Number: | 9039848361 |
NPI Enumeration Date: | 05/15/2008 |
NPI Last Update Date: | 02/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |