Provider Demographics
NPI:1447947643
Name:ZAMORA, VICTORIA LLANES
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LLANES
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:SAN PERLITA
Mailing Address - State:TX
Mailing Address - Zip Code:78590-0223
Mailing Address - Country:US
Mailing Address - Phone:956-248-6362
Mailing Address - Fax:
Practice Address - Street 1:N US 77 SUITE I
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580
Practice Address - Country:US
Practice Address - Phone:956-689-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment