Provider Demographics
NPI:1407448020
Name:ZAPATA, EDWARDO
Entity Type:Individual
Prefix:
First Name:EDWARDO
Middle Name:
Last Name:ZAPATA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5512
Mailing Address - Country:US
Mailing Address - Phone:512-442-1978
Mailing Address - Fax:
Practice Address - Street 1:2400 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5512
Practice Address - Country:US
Practice Address - Phone:512-442-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician