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General NPI Number Information
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NPI Number | 1134694532
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Entity Type | Organization
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Legal Business Name | NATIVIDAD WOUND CARE, LLC
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 138 ZAMORA MEDICAL CIR STE 3
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City | EAGLE PASS
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State | TX
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Zip | 78852-5924
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Country | US
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Telephone | 830-776-5486
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Fax | 830-776-5590
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Provider Business Mailing Address
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Address Line | 138 ZAMORA MEDICAL CIR STE 3
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City | EAGLE PASS
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State | TX
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Zip | 78852-5924
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Country | US
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Telephone | 830-776-5486
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Fax | 830-776-5590
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Authorized Official
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Title or Position | OWNER
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Name | MR. SERGIO ZAMORA
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Credential | DO
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Telephone | 830-757-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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