Provider Demographics
NPI:1134604820
Name:ZAMORANO, LUIGUI (COTA)
Entity type:Individual
Prefix:
First Name:LUIGUI
Middle Name:
Last Name:ZAMORANO
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 N 25TH ST APT 208
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-2819
Mailing Address - Country:US
Mailing Address - Phone:956-366-0171
Mailing Address - Fax:
Practice Address - Street 1:1525 E 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4667
Practice Address - Country:US
Practice Address - Phone:956-969-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215400224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1609013689Medicaid