1437260544 NPI number — JORGE ZAMORA-QUEZADA MD MPH PA

Table of content: (NPI 1437260544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437260544 NPI number — JORGE ZAMORA-QUEZADA MD MPH PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JORGE ZAMORA-QUEZADA MD MPH PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARTHRITIS AND OSTEOPOROSIS CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437260544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 CORNERSTONE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDINBURG
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78539-8479
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-664-1400
Provider Business Mailing Address Fax Number:
956-664-1450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 CORNERSTONE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-8479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-664-1400
Provider Business Practice Location Address Fax Number:
956-664-1450
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZAMORA-QUEZADA
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
PHYSICIAN/SOLE PROPRIETOR
Authorized Official Telephone Number:
956-664-1400

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 156989902 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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