Provider Demographics
NPI:1942704283
Name:ZOOM INITIATIVE INCORPORATED
Entity Type:Organization
Organization Name:ZOOM INITIATIVE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-221-0132
Mailing Address - Street 1:12959 JUPITER RD.
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238
Mailing Address - Country:US
Mailing Address - Phone:214-221-0132
Mailing Address - Fax:214-221-0242
Practice Address - Street 1:12959 JUPITER RD.
Practice Address - Street 2:SUITE 140
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238
Practice Address - Country:US
Practice Address - Phone:214-221-0132
Practice Address - Fax:214-221-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty