Provider Demographics
NPI:1760525745
Name:ZEPEDA, DANIEL GUSTAVO
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:GUSTAVO
Last Name:ZEPEDA
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 1:613 N. 43RD ST.
Mailing Address - Street 2:4311 N. 10TH ST STE G
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8144
Mailing Address - Country:US
Mailing Address - Phone:956-631-9429
Mailing Address - Fax:956-968-4404
Practice Address - Street 1:4311 N. 10RD ST
Practice Address - Street 2:STE G5
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-686-6463
Practice Address - Fax:956-968-4404
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8001493416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport