MEDICARE: MRS. VERONICA C ZAPATA L.M.T.

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	174400000X	Specialist	MT115058	TX

General Provider Information

NPI Number	:	1447661509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA C ZAPATA L.M.T.

Provider Business Mailing Address
First Line	:	2206 NW 24TH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76164-7608
Country	:	US
Telephone Number	:	817-625-4609
Fax Number	:	817-625-4609

Provider Business Practice Location Address
First Line	:	1113 NW 25TH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76164-6904
Country	:	US
Telephone Number	:	817-625-4609
Fax Number	:	817-625-4609

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

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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