Healthcare Provider Details

I. General information

NPI: 1871050823
Provider Name (Legal Business Name): KAREN ZACHARIAS-ENAX RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

794A RUSSELL PALMER RD
KINGWOOD TX
77339-1613
US

IV. Provider business mailing address

11 N FLICKERING SUN CIR
THE WOODLANDS TX
77382-5782
US

V. Phone/Fax

Practice location:
  • Phone: 281-305-0411
  • Fax:
Mailing address:
  • Phone: 210-416-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number784616
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: