MEDICARE: DR. CAROL F ZUCCONE EDD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	23397	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29160	OTHER	TX	DDS

General Provider Information

NPI Number	:	1033295365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL F ZUCCONE EDD

Provider Business Mailing Address
First Line	:	8303 SOUTHWEST FWY
Second Line	:	STE 216
City	:	HOUSTON
State	:	TX
Zip	:	77074-1607
Country	:	US
Telephone Number	:	713-771-3108
Fax Number	:	713-771-3112

Provider Business Practice Location Address
First Line	:	8303 SOUTHWEST FWY
Second Line	:	STE 216
City	:	HOUSTON
State	:	TX
Zip	:	77074-1607
Country	:	US
Telephone Number	:	713-771-3108
Fax Number	:	713-771-3112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2006
Last Update Date	:	07/08/2007

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