Healthcare Provider Details

I. General information

NPI: 1477846061
Provider Name (Legal Business Name): JUAN LUIS ZAMORA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MEDICAL PARKWAY SUITE 208
DALLAS TX
75234
US

IV. Provider business mailing address

8 MEDICAL PARKWAY SUITE 208
DALLAS TX
75234
US

V. Phone/Fax

Practice location:
  • Phone: 972-701-8181
  • Fax: 972-701-8182
Mailing address:
  • Phone: 972-701-8181
  • Fax: 972-701-8182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL D. CASTRO
Title or Position: PROVIDER
Credential: D.C.
Phone: 972-701-8181