Individual
MS. JESSICA RENEE ZACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1500 CITYWEST BLVD STE 300, HOUSTON, TX 77042-2549
(972) 715-0000
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
633024
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP111439
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155266302
—
TX
05
—
155266303
—
TX
05
—
155266304
—
TX
01
—
83362U
BCBS
TX
01
—
P00265383
RAILROAD
TX
Enumeration date
12/22/2005
Last updated
07/16/2020
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