Provider Demographics
NPI:1043377161
Name:ZAPATA COUNTY MEDICAL GROUP
Entity Type:Organization
Organization Name:ZAPATA COUNTY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-765-8494
Mailing Address - Street 1:2329 STOP 23 B
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076
Mailing Address - Country:US
Mailing Address - Phone:956-765-8494
Mailing Address - Fax:
Practice Address - Street 1:801 HWY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076
Practice Address - Country:US
Practice Address - Phone:956-765-8494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty