Provider Demographics
NPI:1730414277
Name:ZDOC PA
Entity type:Organization
Organization Name:ZDOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMUNDO
Authorized Official - Middle Name:OSCAR
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-675-8390
Mailing Address - Street 1:2329 STOP23B
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-3001
Mailing Address - Country:US
Mailing Address - Phone:956-765-8494
Mailing Address - Fax:
Practice Address - Street 1:801 N US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3290
Practice Address - Country:US
Practice Address - Phone:956-765-8494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG1401OtherMEDICAL LICENSE