Provider Demographics
NPI:1467170241
Name:LARA R ZACCA DPM PLLC
Entity Type:Organization
Organization Name:LARA R ZACCA DPM PLLC
Other - Org Name:RIVER OAKS FOOT & ANKLE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LARA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZACCA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:254-739-5744
Mailing Address - Street 1:6550 FANNIN ST STE 2427
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2748
Mailing Address - Country:US
Mailing Address - Phone:832-810-4820
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 2427
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2748
Practice Address - Country:US
Practice Address - Phone:832-573-2587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326453309OtherCOMMERCIALINSURANCE