Individual provider Active NPI

Gus Zamora, M.D.

  • Obstetrics & Gynecology Physician
  • Victoria, TX
National Provider Identifier
1053601518
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
N9014 Issued in TX
Practice address
110 Medical Dr
Suite 100
Victoria, TX 77904-3101
Phone
(361) 578-5233
Fax
(361) 578-0085
NPI assigned
Apr 18, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X N9014 TX Primary

Addresses

Primary practice location

110 Medical Dr
Suite 100
Victoria, TX 77904-3101

Mailing address

110 Medical Dr
Suite 100
Victoria, TX 77904-3101
Phone (361) 578-5233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000269 TX Practitioner - Obstetrics/Gynecology 2769654797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical School at Houston, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victoria Women'S Clinic AssociatesGroup PAC ID 2961494646, 9 clinicians

Practice addresses (Care Compare)

110 Medical Dr
Suite 100
Victoria, TX 77904-3127
Phone (361) 578-5233

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N9014TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Women'S Clinic Associates CurrentSince Jul 31, 2011 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Victoria of Texas LP Past Accepting new patients

Locations

110 Medical Dr
Ste 100
Victoria, TX 77904
Phone (361) 578-5233

110 Medical Dr
Victoria, TX 77904

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1053601518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR",
            "address_2": "SUITE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043101",
            "telephone_number": "361-578-5233",
            "fax_number": "361-578-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR",
            "address_2": "SUITE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043101",
            "telephone_number": "361-578-5233",
            "fax_number": "361-578-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "GUS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N9014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.