Healthcare Provider Details

I. General information

NPI: 1164493862
Provider Name (Legal Business Name): OSVALDO ZAPATA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 MCPHERSON AVE
LAREDO TX
78045-6268
US

IV. Provider business mailing address

105 DEVONSHIRE CT
LAREDO TX
78041-2659
US

V. Phone/Fax

Practice location:
  • Phone: 956-523-2619
  • Fax:
Mailing address:
  • Phone: 956-725-9443
  • Fax: 956-791-5549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number461272
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: