MEDICARE: NADIM M ZACCA MD PA

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00LA14	OTHER	TX	MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1265744866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NADIM M ZACCA MD PA

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	:

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	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NADIM M ZACCA
Credential	:	M.D.
Telephone Number	:	713-795-4059

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	07/12/2010

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Directions to “NADIM M ZACCA MD PA ” Practice Location

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