Healthcare Provider Details

I. General information

NPI: 1609791995
Provider Name (Legal Business Name): LAURA LEE ZAVADIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3117 DAKOTA AVE
SOUTH SIOUX CITY NE
68776-3633
US

IV. Provider business mailing address

6609 HOLLYTREE CIR
TYLER TX
75703-5776
US

V. Phone/Fax

Practice location:
  • Phone: 712-560-2484
  • Fax:
Mailing address:
  • Phone: 712-560-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: