Healthcare Provider Details

I. General information

NPI: 1902225493
Provider Name (Legal Business Name): ZARA OAKES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 06/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 15TH ST
AUSTIN TX
78701-1930
US

IV. Provider business mailing address

PO BOX 4053
AUSTIN TX
78765-4053
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-8355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10049997
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: