Provider Demographics
NPI:1356444681
Name:ZAVALETA, JOSE FERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FERNANDO
Last Name:ZAVALETA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7737 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 415
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-988-0653
Mailing Address - Fax:713-988-8903
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:SUITE 415
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-988-0653
Practice Address - Fax:713-988-8903
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2014-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG2063207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110174711OtherRAILROAD MEDICARE
TX00TU23OtherBC/BS
TX126957303Medicaid
TX126957303Medicaid
TX126957303Medicaid