Provider Demographics
NPI:1447627591
Name:JULIO P ZAVALA MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:JULIO P ZAVALA MEDICAL SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:PAOLO
Authorized Official - Last Name:ZAVALA GEORFFINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-568-7087
Mailing Address - Street 1:104 QUEEN PALM DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-5014
Mailing Address - Country:US
Mailing Address - Phone:956-568-7087
Mailing Address - Fax:
Practice Address - Street 1:104 QUEEN PALM DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-5014
Practice Address - Country:US
Practice Address - Phone:956-568-7087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9039207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1649401589OtherNPI