MEDICARE: DR. GEORGE O ZENNER III 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	207Q00000X	Family Medicine Physician	H2977	TX

General Provider Information

NPI Number	:	1184618001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE O ZENNER III M.D.

Provider Business Mailing Address
First Line	:	5757 WOODWAY DR
Second Line	:	SUITE 260
City	:	HOUSTON
State	:	TX
Zip	:	77057-1514
Country	:	US
Telephone Number	:	713-977-0971
Fax Number	:	713-977-0992

Provider Business Practice Location Address
First Line	:	5757 WOODWAY DR
Second Line	:	STE 260
City	:	HOUSTON
State	:	TX
Zip	:	77057-1514
Country	:	US
Telephone Number	:	713-977-0971
Fax Number	:	713-977-0992

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	02/26/2008

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