Organization
GREG VANZANT, MD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG VANZANT MD (OWNER)
(817) 294-7444
Entity
Organization
Contact information
Practice address
201 WALLS DR, CLEBURNE, TX 76033-4007
(817) 641-2551
Mailing address
PO BOX 102, CLEBURNE, TX 76033-0102
(817) 294-7444
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G8476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006960101
AMERIGROUP
TX
05
—
006960101
—
TX
01
—
00C23C
BCBSTX
TX
01
—
00R82Z
BCBSTX
TX
01
—
084919201
AMERIGROUP
TX
05
—
084919201
—
TX
Enumeration date
10/26/2006
Last updated
02/04/2009
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