MEDICARE: PHEBA ZACHARIAH DO

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	207Q00000X	Family Medicine Physician	036-112510	IL
2	207Q00000X	Family Medicine Physician	2010035689	MO
3	207Q00000X	Family Medicine Physician	P8328	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8EG589	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8FT385	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1861418923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHEBA ZACHARIAH DO

Provider Business Mailing Address
First Line	:	7105 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2210
Country	:	US
Telephone Number	:	281-737-1162
Fax Number	:	281-737-1163

Provider Business Practice Location Address
First Line	:	7105 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2210
Country	:	US
Telephone Number	:	281-737-1162
Fax Number	:	281-737-1163

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	03/22/2023

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Directions to “ PHEBA ZACHARIAH DO” Practice Location

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