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General NPI Number Information
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NPI Number | 1578098166
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Entity Type | Individual
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Provider Name | MARIO PHILLIP ZAMORA MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 17201 INTERSTATE 45 S
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City | THE WOODLANDS
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State | TX
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Zip | 77385-3311
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Country | US
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Telephone | 936-270-3900
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Fax | 936-271-1584
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Provider Business Mailing Address
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Address Line | 17189 INTERSTATE 45 S SUITE 675
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City | THE WOODLANDS
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State | TX
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Zip | 77385-3320
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Country | US
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Telephone | 936-270-3900
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Fax | 936-271-1584
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25IA12408600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | V1717
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 63866
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License Number State | TN
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