Healthcare Provider Details

I. General information

NPI: 1578652947
Provider Name (Legal Business Name): JANICE ZIMMERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 FANNIN ST STE 1001
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

6550 FANNIN ST STE 1001
HOUSTON TX
77030-2740
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-6722
  • Fax:
Mailing address:
  • Phone: 713-441-6722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG5806
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG5806
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: