Healthcare Provider Details

I. General information

NPI: 1487206637
Provider Name (Legal Business Name): PATRICIA ANN ZAPATA PH.D. CRC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W LULLWOOD AVE
SAN ANTONIO TX
78212-2657
US

IV. Provider business mailing address

120 VASSAR LN
SAN ANTONIO TX
78212-1936
US

V. Phone/Fax

Practice location:
  • Phone: 210-473-1905
  • Fax: 210-375-9641
Mailing address:
  • Phone: 210-473-1905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00014344
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: