Provider Demographics
NPI:1952606642
Name:CHARLES W.ZAVALA,M.D.,P.A.
Entity Type:Organization
Organization Name:CHARLES W.ZAVALA,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-541-0162
Mailing Address - Street 1:840 W PRICE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8702
Mailing Address - Country:US
Mailing Address - Phone:956-541-0162
Mailing Address - Fax:956-554-9686
Practice Address - Street 1:840 W PRICE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8702
Practice Address - Country:US
Practice Address - Phone:956-541-0162
Practice Address - Fax:956-554-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0099207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00332359Medicare PIN
TXTXB121640Medicare UPIN