Active NPI
Edgar Zambrano D.O, P.a
- Surgery Physician
- Mt Pleasant, TX
National Provider Identifier
1336302256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- M4680
- Legal business name
- EDGAR ZAMBRANO D.O, P.A
- Practice address
- 103 W 17TH St
Mt Pleasant, TX 75455-2301 - Phone
- (903) 575-9408
- Fax
- (903) 575-9611
- NPI assigned
- Jul 10, 2008
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Dr. Edgar H Zambrano, D.O
- Title
- Ceo
- Phone
- (903) 575-9408
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080909000511 | TX | Part B Supplier - Clinic/Group Practice | 7911073317 |
Receives reassigned benefits from 7 practitioners Practice locations: Mount Pleasant, TX |
National Provider Directory
National Provider DirectoryLocations
3110 E Central Texas Expy
#5
Killeen, TX 76543
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | M4680 | TX | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
103 W 17TH St
Mt Pleasant, TX 75455-2301
Mailing address
PO Box 1685
Mt Pleasant, TX 75456-1685
Phone (903) 575-9408
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0066RV | Other | TX | BLUE CROSS & BLUE SHIELD |
| DO3885 | Other | TX | MEDICARE RAILROAD |
| 196786101 | Medicaid | TX |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 11, 2024.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731283200000",
"number": "1336302256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1685",
"city": "MT PLEASANT",
"state": "TX",
"postal_code": "754561685",
"telephone_number": "903-575-9408",
"fax_number": "903-575-9611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 W 17TH ST",
"city": "MT PLEASANT",
"state": "TX",
"postal_code": "754552301",
"telephone_number": "903-575-9408",
"fax_number": "903-575-9611"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDGAR ZAMBRANO D.O, P.A",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-10",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A",
"authorized_official_last_name": "ZAMBRANO",
"authorized_official_first_name": "EDGAR",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "903-575-9408",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "TX",
"license": "M4680",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "0066RV",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "DO3885",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196786101",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.