Healthcare Provider Details

I. General information

NPI: 1497243216
Provider Name (Legal Business Name): ANNA ZAPATA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 RAWLINS ST APT I
DALLAS TX
75219-4220
US

IV. Provider business mailing address

5615 BRYAN PKWY APT A
DALLAS TX
75206-8171
US

V. Phone/Fax

Practice location:
  • Phone: 214-563-9325
  • Fax:
Mailing address:
  • Phone: 214-563-9325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number74967
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: