Healthcare Provider Details

I. General information

NPI: 1962885517
Provider Name (Legal Business Name): KATHLENE ZUNIGA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 VALHI BLVD
HOUMA LA
70360-5976
US

IV. Provider business mailing address

4820 HENICAN PL
METAIRIE LA
70003-1114
US

V. Phone/Fax

Practice location:
  • Phone: 985-872-3677
  • Fax:
Mailing address:
  • Phone: 504-312-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6578
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: