Provider Demographics
NPI:1487755435
Name:ZAMORA, ROBERT (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-2202
Mailing Address - Country:US
Mailing Address - Phone:956-689-6337
Mailing Address - Fax:956-689-3500
Practice Address - Street 1:180 N 7TH ST
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-2202
Practice Address - Country:US
Practice Address - Phone:956-689-6337
Practice Address - Fax:956-689-3500
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145247Medicaid