Healthcare Provider Details
I. General information
NPI: 1619231677
Provider Name (Legal Business Name): ANTHONY ZAPATA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/25/2012
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3705 MEDICAL PKWY STE 570
AUSTIN TX
78705-1024
US
IV. Provider business mailing address
PO BOX 840853
DALLAS TX
75284-0853
US
V. Phone/Fax
- Phone: 512-454-2554
- Fax: 512-454-2824
- Phone: 972-233-1999
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | R3980 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | BP10042975 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: