Healthcare Provider Details

I. General information

NPI: 1447661509
Provider Name (Legal Business Name): VERONICA C ZAPATA L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 NW 25TH ST
FORT WORTH TX
76164-6904
US

IV. Provider business mailing address

2206 NW 24TH ST
FORT WORTH TX
76164-7608
US

V. Phone/Fax

Practice location:
  • Phone: 817-625-4609
  • Fax: 817-625-4609
Mailing address:
  • Phone: 817-625-4609
  • Fax: 817-625-4609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMT115058
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: