MEDICARE: ZARATE MEDICAL GROUP PA

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	207R00000X	Internal Medicine Physician	M1415	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00W262	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285761809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZARATE MEDICAL GROUP PA

Provider Business Mailing Address
First Line	:	24014 GRAN PALACIO
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-2766
Country	:	US
Telephone Number	:	210-587-8787
Fax Number	:	210-388-0239

Provider Business Practice Location Address
First Line	:	1200 BROOKLYN AVE STE 310
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-4810
Country	:	US
Telephone Number	:	210-587-8787
Fax Number	:	210-388-0239

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RUDOLFO P ZARATE JR.
Credential	:	MD
Telephone Number	:	210-587-8787

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	10/20/2020

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Directions to “ZARATE MEDICAL GROUP PA ” Practice Location

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