Healthcare Provider Details

I. General information

NPI: 1902013238
Provider Name (Legal Business Name): CARLOS ZAVALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 POPLAR CREST CV SUITE 105
MEMPHIS TN
38119-4877
US

IV. Provider business mailing address

1850 POPLAR CREST CV SUITE 105
MEMPHIS TN
38119-4877
US

V. Phone/Fax

Practice location:
  • Phone: 901-300-3232
  • Fax: 901-881-1103
Mailing address:
  • Phone: 901-300-3232
  • Fax: 901-881-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD046284
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberE-14959
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: