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General NPI Number Information
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NPI Number | 1467170241
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Entity Type | Organization
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Legal Business Name | LARA R ZACCA DPM PLLC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 6550 FANNIN ST STE 2427
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City | HOUSTON
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State | TX
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Zip | 77030-2748
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Country | US
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Telephone | 832-573-2587
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Fax |
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Provider Business Mailing Address
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Address Line | 6550 FANNIN ST STE 2427
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City | HOUSTON
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State | TX
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Zip | 77030-2748
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Country | US
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Telephone | 832-810-4820
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | LARA R ZACCA
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Credential | DPM
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Telephone | 254-739-5744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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