Organization Active NPI

Nadim M Zacca MD PA

  • Specialist
  • Houston, TX
National Provider Identifier
1265744866
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
F5420 Issued in TX
Legal business name
NADIM M ZACCA MD PA
Practice address
6550 Fannin St Ste 2229
Houston, TX 77030-2709
Phone
(713) 795-4059
NPI assigned
Jul 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Dr. Nadim M Zacca, M.D.NPI 1114019346
Title
President
Phone
(713) 795-4059

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X F5420 TX Primary

Addresses

Primary practice location

6550 Fannin St Ste 2229
Houston, TX 77030-2709

Mailing address

6550 Fannin St Ste 2229
Houston, TX 77030-2709
Phone (713) 795-4059

Other identifiers 2

IdentifierTypeStateIssuer
00LA14OtherTXMEDICARE PTAN
115444502MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100717000021 TX Part B Supplier - Clinic/Group Practice 6800928409 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

6550 Fannin St
Ste 2229
Houston, TX 77030
Phone (713) 795-4059

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1265744866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST STE 2229",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302709",
            "telephone_number": "713-795-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST STE 2229",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302709",
            "telephone_number": "713-795-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NADIM M ZACCA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "ZACCA",
        "authorized_official_first_name": "NADIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-795-4059",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F5420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  PTAN",
            "identifier": "00LA14",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115444502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.