Individual provider Active NPI

Juan Luis Zamora, MD

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1497774855
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
J3024 Issued in TX
Practice address
7 Medical Pkwy
Suite 100
Dallas, TX 75234-7829
Phone
(972) 701-8181
Fax
(972) 701-8182
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X J3024 TX Primary

Addresses

Primary practice location

7 Medical Pkwy
Suite 100
Dallas, TX 75234-7829

Mailing address

3851 Canot LN
Addison, TX 75001-7904
Phone (214) 631-7203

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
I20090224000322 TX Practitioner - General PracticePractitioner - Pathology 5799840815 Reassigns benefits to 1 organization
Practice locations: Irving, TX

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Rehab Services, Inc. CurrentSince Dec 15, 2018 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497774855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 CANOT LN",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017904",
            "telephone_number": "214-631-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MEDICAL PKWY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347829",
            "telephone_number": "972-701-8181",
            "fax_number": "972-701-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "JUAN",
        "middle_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "J3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.