Healthcare Provider Details

I. General information

NPI: 1699153908
Provider Name (Legal Business Name): ZIPPARO ANESTHESIA CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 ANDREWS HWY
MIDLAND TX
79703-4822
US

IV. Provider business mailing address

PO BOX 4157
MIDLAND TX
79704-4157
US

V. Phone/Fax

Practice location:
  • Phone: 432-887-1111
  • Fax:
Mailing address:
  • Phone: 432-520-0291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP126595
License Number StateTX

VIII. Authorized Official

Name: JEFFREY JOSEPH ZIPPARO
Title or Position: PRESIDENT
Credential: CRNA
Phone: 609-425-5443