Provider Demographics
NPI:1033244397
Name:ZEA, JENNIFER (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ZEA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S WEST DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-1806
Mailing Address - Country:US
Mailing Address - Phone:512-260-0201
Mailing Address - Fax:
Practice Address - Street 1:409 S WEST DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1806
Practice Address - Country:US
Practice Address - Phone:512-260-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor