Provider Demographics
NPI:1326042003
Name:ZAMORA-QUEZADA, JORGE C (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:C
Last Name:ZAMORA-QUEZADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 CORNERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8479
Mailing Address - Country:US
Mailing Address - Phone:956-992-7607
Mailing Address - Fax:956-992-7678
Practice Address - Street 1:2601 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8479
Practice Address - Country:US
Practice Address - Phone:956-664-1400
Practice Address - Fax:956-664-1450
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0739207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156989901Medicaid
TX1326042003OtherNPI
489394ZUQAOtherMEDICARE PROVIDER NUMBER