Provider Demographics
NPI:1003442138
Name:JARRETT, ZACH (DO)
Entity Type:Individual
Prefix:
First Name:ZACH
Middle Name:
Last Name:JARRETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ZACHARY
Other - Middle Name:
Other - Last Name:JARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-P
Mailing Address - Street 2:3551 ROGER BROOKE DR
Mailing Address - City:JBSA FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-2153
Mailing Address - Fax:210-916-0709
Practice Address - Street 1:SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-M
Practice Address - Street 2:3551 ROGER BROOKE DR
Practice Address - City:JBSA FORT SAM HOUSTON
Practice Address - State:TN
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-5910
Practice Address - Fax:210-916-2077
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1003442138207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program