Provider Demographics
NPI:1588209506
Name:ZAMORA, CARLIE AARON (RN, LBSW, CCM, CPC)
Entity Type:Individual
Prefix:
First Name:CARLIE
Middle Name:AARON
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:RN, LBSW, CCM, CPC
Other - Prefix:
Other - First Name:CARLIE
Other - Middle Name:AARON
Other - Last Name:BLEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2424 WILCREST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2772
Mailing Address - Country:US
Mailing Address - Phone:713-666-8287
Mailing Address - Fax:
Practice Address - Street 1:5630 COHN TER
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-1198
Practice Address - Country:US
Practice Address - Phone:281-814-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX819889163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse