Individual
JOSE GONZALO ZAVALETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1804 W MEDALIST RD, PINEVILLE, LA 71360-2619
(318) 641-7800
Mailing address
1804 W MEDALIST RD, PINEVILLE, LA 71360-2619
(318) 641-7800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12742R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1496065
—
LA
Enumeration date
10/24/2006
Last updated
07/29/2008
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