Healthcare Provider Details

I. General information

NPI: 1679873699
Provider Name (Legal Business Name): HELEN CECILLE ZOOK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W KOENIG LN 100
AUSTIN TX
78751-1213
US

IV. Provider business mailing address

101 W KOENIG LN 100
AUSTIN TX
78751-1213
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-9426
  • Fax: 512-454-7294
Mailing address:
  • Phone: 512-454-9426
  • Fax: 512-454-7294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00240
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: