Provider Demographics
NPI:1114552528
Name:ATZ PRIMARY CARE, INC.
Entity Type:Organization
Organization Name:ATZ PRIMARY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-579-7881
Mailing Address - Street 1:2024 N MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-6906
Mailing Address - Country:US
Mailing Address - Phone:956-579-7881
Mailing Address - Fax:956-621-1588
Practice Address - Street 1:2024 N MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-6906
Practice Address - Country:US
Practice Address - Phone:956-579-7881
Practice Address - Fax:956-621-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5797881Medicaid