Provider Demographics
NPI:1043315542
Name:ZAMBRANO, JACINTO JR (MD)
Entity type:Individual
Prefix:
First Name:JACINTO
Middle Name:
Last Name:ZAMBRANO
Suffix:JR
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3500 HEALTHPLEX PKWY # 102
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9738
Mailing Address - Country:US
Mailing Address - Phone:405-307-6955
Mailing Address - Fax:830-258-7098
Practice Address - Street 1:3500 HEALTHPLEX PKWY # 102
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9738
Practice Address - Country:US
Practice Address - Phone:053-076-9554
Practice Address - Fax:405-307-6957
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF21382083P0011X, 2086S0122X
OK354512083P0011X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127511707Medicaid