Provider Demographics
NPI:1083091565
Name:ZEN ORTHOPEDICS, PLLC
Entity Type:Organization
Organization Name:ZEN ORTHOPEDICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT LAC
Authorized Official - Phone:917-608-9304
Mailing Address - Street 1:2901 CITYPLACE WEST BLVD
Mailing Address - Street 2:SUITE 617
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-0300
Mailing Address - Country:US
Mailing Address - Phone:917-608-9304
Mailing Address - Fax:
Practice Address - Street 1:2901 CITYPLACE WEST BLVD
Practice Address - Street 2:SUITE 617
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-0300
Practice Address - Country:US
Practice Address - Phone:917-608-9304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3587171100000X
NY005464-1171100000X
NY0266352251X0800X
FL216142251X0800X
COPTL00112942251X0800X
HI33722251X0800X
TX12415002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty