Provider Demographics
NPI:1861961252
Name:ZAVALA, RAMON (LPTA)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:ZAVALA
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W COUNTY ROAD 2163
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-8882
Mailing Address - Country:US
Mailing Address - Phone:361-228-1202
Mailing Address - Fax:
Practice Address - Street 1:138 S FM 1329
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:TX
Practice Address - Zip Code:78384-3925
Practice Address - Country:US
Practice Address - Phone:361-279-8291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2019147208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation