Healthcare Provider Details

I. General information

NPI: 1689346413
Provider Name (Legal Business Name): JENNIFER ZUROVEC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ZUROVEC

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4204 BALCONES WOODS DR
AUSTIN TX
78759-5012
US

IV. Provider business mailing address

4000 S. I-H 35 FRONTAGE RD
AUSTIN TX
78704
US

V. Phone/Fax

Practice location:
  • Phone: 512-970-2186
  • Fax:
Mailing address:
  • Phone: 512-414-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number109825
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: