Provider Demographics
NPI:1710613781
Name:ZAMARRON, CARSON RAY (APRN)
Entity Type:Individual
Prefix:
First Name:CARSON
Middle Name:RAY
Last Name:ZAMARRON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11539 HUEBNER RD APT 3116
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1772
Mailing Address - Country:US
Mailing Address - Phone:512-820-2210
Mailing Address - Fax:
Practice Address - Street 1:225 E SONTERRA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3996
Practice Address - Country:US
Practice Address - Phone:210-403-2926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1088831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily