Healthcare Provider Details

I. General information

NPI: 1053531269
Provider Name (Legal Business Name): ZACHARY R. WINDROW, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 AVENUE E
HONDO TX
78861-3534
US

IV. Provider business mailing address

1204 OAK LN
HONDO TX
78861-1009
US

V. Phone/Fax

Practice location:
  • Phone: 830-426-7444
  • Fax: 830-426-7468
Mailing address:
  • Phone: 830-426-7444
  • Fax: 830-426-7468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ8843
License Number StateTX

VIII. Authorized Official

Name: DR. ZACHARY R WINDROW
Title or Position: PHYSICIAN
Credential: MD
Phone: 830-426-7444