Healthcare Provider Details

I. General information

NPI: 1336106913
Provider Name (Legal Business Name): SARA L ZALETA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 ED HALL DR STE B-108
KAUFMAN TX
75142-1861
US

IV. Provider business mailing address

874 ED HALL DR STE B-108
KAUFMAN TX
75142-1861
US

V. Phone/Fax

Practice location:
  • Phone: 972-932-5555
  • Fax: 972-932-5557
Mailing address:
  • Phone: 972-932-5555
  • Fax: 972-932-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL9029
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL9029
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: