Healthcare Provider Details

I. General information

NPI: 1831679729
Provider Name (Legal Business Name): JENNIFER CHRISTINE ZAPATA M.S., CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17521 HIGHWAY 69 S STE 120
TYLER TX
75703-5596
US

IV. Provider business mailing address

8308 CORI LN
FRISCO TX
75033-2570
US

V. Phone/Fax

Practice location:
  • Phone: 903-839-3600
  • Fax:
Mailing address:
  • Phone: 214-738-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15695
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: