Healthcare Provider Details

I. General information

NPI: 1235678079
Provider Name (Legal Business Name): LUIS ZAPATA JR. FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 E GRIFFIN PKWY STE 2
MISSION TX
78572-2422
US

IV. Provider business mailing address

1512 E GRIFFIN PKWY STE 2
MISSION TX
78572-2422
US

V. Phone/Fax

Practice location:
  • Phone: 956-519-7088
  • Fax: 956-519-9816
Mailing address:
  • Phone: 956-519-7088
  • Fax: 956-519-9816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP133105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: