1275712572 NPI number — STANLEY J. ZIMMERMAN, M.D. AND ASSOCIATES

Table of content: (NPI 1275712572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275712572 NPI number — STANLEY J. ZIMMERMAN, M.D. AND ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STANLEY J. ZIMMERMAN, M.D. AND ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275712572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7707 FANNIN ST
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054-1926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-797-9999
Provider Business Mailing Address Fax Number:
713-795-4651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7707 FANNIN ST
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77054-1926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-797-9999
Provider Business Practice Location Address Fax Number:
713-795-4651
Provider Enumeration Date:
11/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CORNWALL
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS OFFICE MANAGER
Authorized Official Telephone Number:
713-797-9999

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  C5307 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 083791601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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