Healthcare Provider Details

I. General information

NPI: 1649334855
Provider Name (Legal Business Name): CHRISTINA DOLORES ZOTTO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 HART ST 82 MEDICAL GROUP SGSP
SHEPPARD AFB TX
76311-3477
US

IV. Provider business mailing address

2954 S SHEPHERDS GLN
WICHITA FALLS TX
76308-5449
US

V. Phone/Fax

Practice location:
  • Phone: 940-676-5941
  • Fax:
Mailing address:
  • Phone: 940-343-1466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202010428
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: