Healthcare Provider Details

I. General information

NPI: 1013754894
Provider Name (Legal Business Name): DOMINICK L ZAVALA PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S D ST
MCALLEN TX
78503-1854
US

IV. Provider business mailing address

2001 S D ST
MCALLEN TX
78503-1854
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-2242
  • Fax: 956-686-3515
Mailing address:
  • Phone: 956-686-2242
  • Fax: 956-686-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: