Individual
BERNICE ZACNITE ESTEGHAMATDARSHAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
6801 MCPHERSON RD STE 331, LAREDO, TX 78041-6417
(956) 722-9918
(956) 722-0829
Mailing address
P.O. BOX 450329, LAREDO, TX 78045-0329
(956) 722-9918
(956) 722-0829
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08752
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328900101
—
TX
Enumeration date
10/11/2013
Last updated
04/30/2014
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