Healthcare Provider Details

I. General information

NPI: 1255636643
Provider Name (Legal Business Name): MARTHA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 1ST ST E
HUMBLE TX
77338-4605
US

IV. Provider business mailing address

514 1ST ST E
HUMBLE TX
77338-4605
US

V. Phone/Fax

Practice location:
  • Phone: 281-359-8998
  • Fax: 281-446-7774
Mailing address:
  • Phone: 281-359-8998
  • Fax: 281-446-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number64750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: