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General NPI Number Information
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NPI Number | 1942704283
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Entity Type | Organization
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Legal Business Name | ZOOM INITIATIVE INCORPORATED
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 12959 JUPITER RD. SUITE 140
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 214-221-0132
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Fax | 214-221-0242
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Provider Business Mailing Address
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Address Line | 12959 JUPITER RD. SUITE 140
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 214-221-0132
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Fax | 214-221-0242
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GEORGE NEBE
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Credential |
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Telephone | 214-221-0132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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