Healthcare Provider Details

I. General information

NPI: 1225899735
Provider Name (Legal Business Name): IVETTE ZAPATA M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6406 MCPHERSON RD STE 2
LAREDO TX
78041-6258
US

IV. Provider business mailing address

3117 CLEVELAND ST
LAREDO TX
78043-5310
US

V. Phone/Fax

Practice location:
  • Phone: 956-723-7457
  • Fax:
Mailing address:
  • Phone: 956-898-2198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number84313
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: