Provider Demographics
NPI:1346575867
Name:ZARZOUR, ANDRE YOUSSEF (MD)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:YOUSSEF
Last Name:ZARZOUR
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 1:8615 HERTS RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6720
Mailing Address - Country:US
Mailing Address - Phone:281-743-3442
Mailing Address - Fax:281-379-1465
Practice Address - Street 1:8615 HERTS RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6720
Practice Address - Country:US
Practice Address - Phone:281-743-3442
Practice Address - Fax:281-379-1465
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD55832080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXUE57369Medicare UPIN