Healthcare Provider Details

I. General information

NPI: 1558509620
Provider Name (Legal Business Name): ZAE Y. ZEON M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 NORTH FWY SUITE # 107
HOUSTON TX
77076-2941
US

IV. Provider business mailing address

6500 NORTH FWY SUITE # 107
HOUSTON TX
77076-2941
US

V. Phone/Fax

Practice location:
  • Phone: 713-694-3900
  • Fax: 713-694-5563
Mailing address:
  • Phone: 713-694-3900
  • Fax: 713-694-5563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberF5421
License Number StateTX

VIII. Authorized Official

Name: DR. ZAE Y ZEON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 713-694-3900