MEDICARE: RUSSELL GARCIA ZAMAR PA-C

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	363AM0700X	Medical Physician Assistant	PA20047	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1841756236	OTHER	TX	GROUP

General Provider Information

NPI Number	:	1548066822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL GARCIA ZAMAR PA-C

Provider Business Mailing Address
First Line	:	27150 HIGHWAY 290
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-7223
Country	:	US
Telephone Number	:	832-653-3300
Fax Number	:	832-653-6407

Provider Business Practice Location Address
First Line	:	27150 HIGHWAY 290 STE 100
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-7224
Country	:	US
Telephone Number	:	832-653-3300
Fax Number	:	832-653-6407

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

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	04/07/2026

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