Provider Demographics
NPI:1528393949
Name:GLORIA ZEGARRUNDO
Entity Type:Organization
Organization Name:GLORIA ZEGARRUNDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:ZAIDA
Authorized Official - Last Name:ZEGARRUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:281-497-2202
Mailing Address - Street 1:3414 SHADOWFERN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2346
Mailing Address - Country:US
Mailing Address - Phone:281-497-2202
Mailing Address - Fax:
Practice Address - Street 1:3414 SHADOWFERN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2346
Practice Address - Country:US
Practice Address - Phone:281-497-2202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-04
Last Update Date:2009-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137206314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility