Healthcare Provider Details

I. General information

NPI: 1588024467
Provider Name (Legal Business Name): GREGORY ZARCONE MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 S JEFFERSON AVE
MT PLEASANT TX
75455-5355
US

IV. Provider business mailing address

1312 S JEFFERSON AVE
MT PLEASANT TX
75455-5355
US

V. Phone/Fax

Practice location:
  • Phone: 903-572-9700
  • Fax: 903-572-2447
Mailing address:
  • Phone: 903-572-9700
  • Fax: 903-572-2447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberL8252
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberL8252
License Number StateTX

VIII. Authorized Official

Name: TRENT CARGILE
Title or Position: MANAGER
Credential:
Phone: 903-305-4450