Provider Demographics
NPI:1639990088
Name:ZABALETA, MARIA EUGENIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:EUGENIA
Last Name:ZABALETA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CAKE ARCO IRIS N 155
Mailing Address - Street 2:
Mailing Address - City:FRACCIONAMIENTO NUEVO PROGRESO
Mailing Address - State:TAMAULIPAS
Mailing Address - Zip Code:88123
Mailing Address - Country:MX
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7768
Practice Address - Country:US
Practice Address - Phone:956-375-4695
Practice Address - Fax:956-375-4695
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6161072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist