Provider Demographics
NPI:1649334855
Name:ZOTTO, CHRISTINA DOLORES (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DOLORES
Last Name:ZOTTO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2954 S SHEPHERDS GLN
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-5449
Mailing Address - Country:US
Mailing Address - Phone:940-343-1466
Mailing Address - Fax:
Practice Address - Street 1:149 HART ST
Practice Address - Street 2:82 MEDICAL GROUP SGSP
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311-3477
Practice Address - Country:US
Practice Address - Phone:940-676-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist