MEDICARE: DR. EDGAR ZAMBRANO D.O.

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	208600000X	Surgery Physician	M4680	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00676257	OTHER	TX	MEDICARE RAILROAD

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
3	8BS780	OTHER	TX	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1780718767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDGAR ZAMBRANO D.O.

Provider Business Mailing Address
First Line	:	PO BOX 1685
Second Line	:
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75456-1685
Country	:	US
Telephone Number	:	903-575-9408
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 MULBERRY AVE
Second Line	:	SUITE 210
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75455-2312
Country	:	US
Telephone Number	:	903-575-9408
Fax Number	:

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	01/19/2023

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Directions to “ DR. EDGAR ZAMBRANO D.O.” Practice Location

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