Healthcare Provider Details

I. General information

NPI: 1710360318
Provider Name (Legal Business Name): KARLA ZAVALA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 MONTANA AVE
EL PASO TX
79925-2155
US

IV. Provider business mailing address

3812 MCCONNELL AVE
EL PASO TX
79904-6117
US

V. Phone/Fax

Practice location:
  • Phone: 956-561-1386
  • Fax:
Mailing address:
  • Phone: 956-561-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number116715
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: