Provider Demographics
NPI:1992266498
Name:ZARA MEDICAL AESTETICS, PLLC
Entity type:Organization
Organization Name:ZARA MEDICAL AESTETICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:I
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:830-587-4888
Mailing Address - Street 1:1928 HIGHWAY 46 W STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-0022
Mailing Address - Country:US
Mailing Address - Phone:830-587-4888
Mailing Address - Fax:512-641-6150
Practice Address - Street 1:1928 HIGHWAY 46 W #105
Practice Address - Street 2:SUIE 208
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132
Practice Address - Country:US
Practice Address - Phone:830-587-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty