Provider Demographics
NPI:1619141363
Name:ZAVALETA, ERIC MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:MATTHEW
Last Name:ZAVALETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 HEALTH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1224
Mailing Address - Country:US
Mailing Address - Phone:325-690-4429
Mailing Address - Fax:325-690-4438
Practice Address - Street 1:5441 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606
Practice Address - Country:US
Practice Address - Phone:325-690-4429
Practice Address - Fax:325-690-4438
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30871207W00000X
TXN1239207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist