MEDICARE: DR. NADIM MICHELL ZACCA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	F5420	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114019346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADIM MICHELL ZACCA M.D.

Provider Business Mailing Address
First Line	:	6550 FANNIN ST STE 2229
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2709
Country	:	US
Telephone Number	:	713-795-4059
Fax Number	:	713-795-5732

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 2229
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2709
Country	:	US
Telephone Number	:	713-795-4059
Fax Number	:	713-795-5732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	01/03/2008

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