Individual
MIMI A ZUMWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-0002
(806) 743-2475
(806) 743-1394
Mailing address
PO BOX 5865, LUBBOCK, TX 79430-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
K8867
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
K8867
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078050A
—
OK
05
—
105457901
—
TX
05
—
105457903
—
TX
01
—
127647100
FIRSTCARE COMMERCIAL
TX
05
—
127647101
—
TX
01
—
64481
PRESBYTERIAN COMMERCIAL
NM
05
—
64481
—
NM
05
—
66627
—
NM
01
—
81155S
BC/BS
TX
01
—
84308Z
HMO BLUE
TX
01
—
A033
TRIWEST
NM
01
—
X0112999
DPS
TX
Enumeration date
11/11/2005
Last updated
05/11/2023
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