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General NPI Number Information
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NPI Number | 1134769789
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Entity Type | Organization
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Legal Business Name | IES CARROLLTON PLLC
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Dates
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Enumeration Date | 01/12/2020
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 4343 N JOSEY LN
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City | CARROLLTON
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State | TX
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Zip | 75010-4603
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Country | US
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Telephone | 469-420-5527
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1343
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-1343
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Country | US
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Telephone | 469-420-5527
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NESTOR R ZENAROSA
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Credential | MD
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Telephone | 469-420-5527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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