Healthcare Provider Details

I. General information

NPI: 1790973121
Provider Name (Legal Business Name): JOHN A. ZAVALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SUMMER LEE DRIVE
ROCKWALL TX
75032-5452
US

IV. Provider business mailing address

1301 SUMMER LEE DRIVE
ROCKWALL TX
75032-5452
US

V. Phone/Fax

Practice location:
  • Phone: 972-771-8111
  • Fax: 972-771-8103
Mailing address:
  • Phone: 972-771-8111
  • Fax: 972-771-8103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberN6793
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberN6793
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: