Provider Demographics
NPI:1972529469
Name:ZEST FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:ZEST FAMILY MEDICINE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:512-379-7272
Mailing Address - Street 1:1201 N LAKELINE BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6781
Mailing Address - Country:US
Mailing Address - Phone:512-379-7272
Mailing Address - Fax:512-379-7271
Practice Address - Street 1:1201 N LAKELINE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6781
Practice Address - Country:US
Practice Address - Phone:512-379-7272
Practice Address - Fax:512-379-7271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 261QP2300X
TX669894363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780221598OtherGROUP NPI
TX00971ZMedicare Oscar/Certification
TXQ61197Medicare UPIN