Individual
ANDREW JOHN ZOVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
(337) 494-6767
(337) 494-6750
Mailing address
1525 OAK PARK BLVD, LAKE CHARLES, LA 70601-8849
(337) 494-6767
(337) 494-6750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
312473
LA
207Q00000X
Family Medicine Physician
S8409
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425653901
—
TX
01
—
Q00277466
RAILROAD MEDICARE PTAN
TX
Enumeration date
04/10/2018
Last updated
08/30/2022
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