Provider Demographics
NPI:1003523002
Name:IES CENTRAL TEXAS PLLC
Entity Type:Organization
Organization Name:IES CENTRAL TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AO
Authorized Official - Prefix:
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-420-5527
Mailing Address - Street 1:PO BOX 3246
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3246
Mailing Address - Country:US
Mailing Address - Phone:727-798-5450
Mailing Address - Fax:
Practice Address - Street 1:101 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2670
Practice Address - Country:US
Practice Address - Phone:254-580-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty