Provider Demographics
NPI:1588024467
Name:GREGORY ZARCONE MD, PLLC
Entity Type:Organization
Organization Name:GREGORY ZARCONE MD, PLLC
Other - Org Name:MEDIKIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CARGILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-305-4450
Mailing Address - Street 1:1312 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-5355
Mailing Address - Country:US
Mailing Address - Phone:903-572-9700
Mailing Address - Fax:903-572-2447
Practice Address - Street 1:1312 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-5355
Practice Address - Country:US
Practice Address - Phone:903-572-9700
Practice Address - Fax:903-572-2447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8252261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care