Provider Demographics
NPI:1558509620
Name:ZAE Y. ZEON M.D., P.A.
Entity Type:Organization
Organization Name:ZAE Y. ZEON M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ZEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-694-3900
Mailing Address - Street 1:6500 NORTH FWY
Mailing Address - Street 2:SUITE # 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-2941
Mailing Address - Country:US
Mailing Address - Phone:713-694-3900
Mailing Address - Fax:713-694-5563
Practice Address - Street 1:6500 NORTH FWY
Practice Address - Street 2:SUITE # 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-2941
Practice Address - Country:US
Practice Address - Phone:713-694-3900
Practice Address - Fax:713-694-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5421208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200178601Medicaid
0A3218Medicare PIN
8F10245Medicare PIN