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General NPI Number Information
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NPI Number | 1336302256
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Entity Type | Organization
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Legal Business Name | EDGAR ZAMBRANO D.O, P.A
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 103 W 17TH ST
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City | MT PLEASANT
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State | TX
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Zip | 75455-2301
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Country | US
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Telephone | 903-575-9408
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Fax | 903-575-9611
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Provider Business Mailing Address
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Address Line | PO BOX 1685
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City | MT PLEASANT
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State | TX
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Zip | 75456-1685
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Country | US
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Telephone | 903-575-9408
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Fax | 903-575-9611
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Authorized Official
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Title or Position | CEO
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Name | DR. EDGAR H ZAMBRANO
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Credential | D.O
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Telephone | 903-575-9408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M4680
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License Number State | TX
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