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General NPI Number Information
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NPI Number | 1023897477
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Entity Type | Individual
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Provider Name | JUAN MANUEL ZAMBRANO PETIT
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Gender | Male
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 9211 FM 723 RD
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City | RICHMOND
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State | TX
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Zip | 77406-9237
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Country | US
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Telephone | 281-232-5500
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Fax | 346-239-3583
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Provider Business Mailing Address
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Address Line | 11230 VICTORIA HOLLOW TRCE
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City | RICHMOND
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State | TX
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Zip | 77406-2726
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Country | US
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Telephone | 713-517-6139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 311816
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License Number State | TX
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