MEDICARE: HELEN CECILLE ZOOK 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	PA00240	TX

General Provider Information

NPI Number	:	1679873699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN CECILLE ZOOK PA-C

Provider Business Mailing Address
First Line	:	101 W KOENIG LN
Second Line	:	100
City	:	AUSTIN
State	:	TX
Zip	:	78751-1213
Country	:	US
Telephone Number	:	512-454-9426
Fax Number	:	512-454-7294

Provider Business Practice Location Address
First Line	:	101 W KOENIG LN
Second Line	:	100
City	:	AUSTIN
State	:	TX
Zip	:	78751-1213
Country	:	US
Telephone Number	:	512-454-9426
Fax Number	:	512-454-7294

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

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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