Provider Demographics
NPI:1639650435
Name:ZAMORANOS, PAOLO
Entity Type:Individual
Prefix:
First Name:PAOLO
Middle Name:
Last Name:ZAMORANOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17119 PECAN ACRES DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4854
Mailing Address - Country:US
Mailing Address - Phone:310-803-7858
Mailing Address - Fax:
Practice Address - Street 1:17119 PECAN ACRES DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4854
Practice Address - Country:US
Practice Address - Phone:310-803-7858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2109381225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant