Provider Demographics
NPI:1124687256
Name:ZAMZAM, NORA (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:
Last Name:ZAMZAM
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 ALASKA DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-7720
Mailing Address - Country:US
Mailing Address - Phone:909-747-4353
Mailing Address - Fax:972-692-8541
Practice Address - Street 1:1124 ALASKA DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-7720
Practice Address - Country:US
Practice Address - Phone:909-747-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86070015133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered