Provider Demographics
NPI:1710098694
Name:ZWAAN, JOHAN THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:JOHAN
Middle Name:THOMAS
Last Name:ZWAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8038 WURZBACH RD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3817
Mailing Address - Country:US
Mailing Address - Phone:210-615-8474
Mailing Address - Fax:210-615-0919
Practice Address - Street 1:8038 WURZBACH RD
Practice Address - Street 2:SUITE 520
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3817
Practice Address - Country:US
Practice Address - Phone:210-615-8474
Practice Address - Fax:210-615-0919
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH7530207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB76730Medicare UPIN
TX8G1980Medicare PIN