Healthcare Provider Details

I. General information

NPI: 1730802497
Provider Name (Legal Business Name): JORDAN SCOTT ZANGARINE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7304 LOUETTA RD
SPRING TX
77379-7234
US

IV. Provider business mailing address

4848 PIN OAK PARK APT 1318
HOUSTON TX
77081-2291
US

V. Phone/Fax

Practice location:
  • Phone: 281-379-1317
  • Fax:
Mailing address:
  • Phone: 469-226-7848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71346
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: