Provider Demographics
NPI:1003929563
Name:ZUMMO, GINA NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:NICOLE
Last Name:ZUMMO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1560 ELDRIDGE PKWY STE 132
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1763
Mailing Address - Country:US
Mailing Address - Phone:281-293-9180
Mailing Address - Fax:281-293-9181
Practice Address - Street 1:1560 ELDRIDGE PKWY STE 132
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1763
Practice Address - Country:US
Practice Address - Phone:281-293-9180
Practice Address - Fax:281-293-9181
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor