Provider Demographics
NPI:1598072217
Name:ELOY ZAMARRON, MD PA
Entity Type:Organization
Organization Name:ELOY ZAMARRON, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELOY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMARRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-728-0323
Mailing Address - Street 1:6801 MCPHERSON RD STE 109
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6403
Mailing Address - Country:US
Mailing Address - Phone:956-728-0323
Mailing Address - Fax:956-728-8130
Practice Address - Street 1:6801 MCPHERSON RD STE 109
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6403
Practice Address - Country:US
Practice Address - Phone:956-728-0323
Practice Address - Fax:956-728-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5958207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126966402Medicaid
TXTXB112639OtherMEDICARE PTAN
TX126966402Medicaid
TX00R33PMedicare PIN