Provider Demographics
NPI:1245002989
Name:ZAPATA PRIMARY CARE CLINIC LLC
Entity type:Organization
Organization Name:ZAPATA PRIMARY CARE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-774-6020
Mailing Address - Street 1:7521 COUNTRY CLUB DR APT 506
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3398
Mailing Address - Country:US
Mailing Address - Phone:956-774-6020
Mailing Address - Fax:
Practice Address - Street 1:105 S US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3747
Practice Address - Country:US
Practice Address - Phone:956-750-3429
Practice Address - Fax:956-750-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty