Provider Demographics
NPI:1962429472
Name:JOSE ZAMORA MD PA
Entity type:Organization
Organization Name:JOSE ZAMORA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-449-0891
Mailing Address - Street 1:PO BOX 1407
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-9998
Mailing Address - Country:US
Mailing Address - Phone:361-389-4135
Mailing Address - Fax:956-546-3406
Practice Address - Street 1:4302 S SUGAR RD STE 106
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9140
Practice Address - Country:US
Practice Address - Phone:956-465-0766
Practice Address - Fax:956-465-0745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6427174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130555907Medicaid
TX164541801Medicaid
TX00305WMedicare ID - Type UnspecifiedMEDICARE NUMBER
TXD69315Medicare UPIN