Healthcare Provider Details

I. General information

NPI: 1629380951
Provider Name (Legal Business Name): ZSHAHMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 HANZ DR
NEW BRAUNFELS TX
78130-2567
US

IV. Provider business mailing address

176 ROYAL GEORGE CIR
MC QUEENEY TX
78123-3413
US

V. Phone/Fax

Practice location:
  • Phone: 702-453-3799
  • Fax: 702-453-5741
Mailing address:
  • Phone: 702-453-3799
  • Fax: 702-453-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM3733
License Number StateTX

VIII. Authorized Official

Name: LORI ANN LABRECQUE
Title or Position: ACCTS MGR
Credential:
Phone: 702-453-3799