NPIMap

Organization Active NPI

Dr Sergio Zamora, PA

  • Family Medicine Physician
  • Eagle Pass, TX
National Provider Identifier
1265734248
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DR SERGIO ZAMORA, PA
Practice address
2450 El Indio Hwy
Eagle Pass, TX 78852-6615
Phone
(830) 757-3900
Fax
(830) 757-3838
NPI assigned
Nov 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Dr. Sergio Zamora, M.D., D.O.NPI 1467412189
Title
President
Phone
(830) 757-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2450 El Indio Hwy
Eagle Pass, TX 78852-6615

Mailing address

2450 El Indio Hwy
Eagle Pass, TX 78852-6615
Phone (830) 757-3900

Other identifiers 1

IdentifierTypeStateIssuer
137895204MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111228000602 TX Part B Supplier - Clinic/Group Practice 7810163615 Receives reassigned benefits from 3 practitioners
Practice locations: Eagle Pass, TX

National Provider Directory

National Provider Directory

Locations

2450 El Indio Hwy
Eagle Pass, TX 78852
Phone (210) 807-8796

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1265734248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 EL INDIO HWY",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526615",
            "telephone_number": "830-757-3900",
            "fax_number": "830-757-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 EL INDIO HWY",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526615",
            "telephone_number": "830-757-3900",
            "fax_number": "830-757-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SERGIO ZAMORA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-757-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137895204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.