Provider Demographics
NPI:1366866477
Name:VICTORIA PROFESSIONAL MEDICAL CONSULTANTS, LLC
Entity Type:Organization
Organization Name:VICTORIA PROFESSIONAL MEDICAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-240-1159
Mailing Address - Street 1:PO BOX 3689
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-3310
Mailing Address - Country:US
Mailing Address - Phone:800-962-3303
Mailing Address - Fax:405-682-1586
Practice Address - Street 1:815 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:PORT LAVACA
Practice Address - State:TX
Practice Address - Zip Code:77979-3025
Practice Address - Country:US
Practice Address - Phone:361-552-6713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty