Healthcare Provider Details

I. General information

NPI: 1245892751
Provider Name (Legal Business Name): RODOLFO ELOY ZAPATA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9032 DUGAS RD APT 118
SAN ANTONIO TX
78251
US

IV. Provider business mailing address

9032 DUGAS RD APT 118
SAN ANTONIO TX
78251
US

V. Phone/Fax

Practice location:
  • Phone: 210-291-4086
  • Fax:
Mailing address:
  • Phone: 210-291-4086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: