Provider Demographics
NPI:1356483267
Name:MILDRED P. ZAFRA ,MDPA
Entity Type:Organization
Organization Name:MILDRED P. ZAFRA ,MDPA
Other - Org Name:ALL CHILDREN'S HEALTHCARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:P
Authorized Official - Last Name:ZAFRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-881-8228
Mailing Address - Street 1:1225 AGNES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78401-3226
Mailing Address - Country:US
Mailing Address - Phone:361-881-8228
Mailing Address - Fax:361-881-8243
Practice Address - Street 1:1225 AGNES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-3226
Practice Address - Country:US
Practice Address - Phone:361-881-8228
Practice Address - Fax:361-881-8243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6429208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122365305Medicaid
G81146Medicare UPIN