Healthcare Provider Details

I. General information

NPI: 1750039491
Provider Name (Legal Business Name): DOMINGO ZAPATA LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 24TH AVE
EDINBURG TX
78539-6533
US

IV. Provider business mailing address

1901 S 24TH AVE
EDINBURG TX
78539-6533
US

V. Phone/Fax

Practice location:
  • Phone: 956-289-7000
  • Fax: 956-289-7257
Mailing address:
  • Phone: 956-289-7000
  • Fax: 956-289-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: