Healthcare Provider Details

I. General information

NPI: 1083155527
Provider Name (Legal Business Name): ANNE JENENE ZUROVEC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19965 FM 3175
LYTLE TX
78052-3481
US

IV. Provider business mailing address

PO BOX 725
LYTLE TX
78052-0725
US

V. Phone/Fax

Practice location:
  • Phone: 210-357-0395
  • Fax:
Mailing address:
  • Phone: 210-357-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number118222
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: