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General NPI Number Information
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NPI Number | 1275550360
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Entity Type | Organization
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Legal Business Name | LAS COLINAS OBSTETRICS GYNECOLOGY & INFERTILITY ASSOCIATION P A
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 3501 N. MACARTHUR BLVD. STE. 350
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City | IRVING
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State | TX
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Zip | 75062-3600
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Country | US
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Telephone | 972-257-5300
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Fax | 972-257-5320
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Provider Business Mailing Address
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Address Line | 3501 N. MACARTHUR BLVD. STE. 350
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City | IRVING
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State | TX
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Zip | 75062-3600
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Country | US
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Telephone | 972-257-5300
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Fax | 972-257-5322
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOHN J ZAVALETA
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Credential | MD
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Telephone | 972-257-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | J3676
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G0320
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License Number State | TX
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