MEDICARE: MR. OMAR STEVE ZAPATA 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	363A00000X	Physician Assistant	307647	LA

General Provider Information

NPI Number	:	1821500596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. OMAR STEVE ZAPATA PA-C

Provider Business Mailing Address
First Line	:	3488 BRENTWOOD DR STE 103
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-2015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7742 OFFICE PARK BLVD STE C3
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-8636
Country	:	US
Telephone Number	:	225-448-0440
Fax Number	:

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

Provider Enumeration Date	:	11/02/2017
Last Update Date	:	05/02/2024

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