Basic Information
| Provider Information | |||||||||
| NPI: | 1053531269 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZACHARY R. WINDROW, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1204 OAK LN | ||||||||
| Address2: | |||||||||
| City: | HONDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788611009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8304267444 | ||||||||
| FaxNumber: | 8304267468 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 AVENUE E | ||||||||
| Address2: | |||||||||
| City: | HONDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788613534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8304267444 | ||||||||
| FaxNumber: | 8304267468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2007 | ||||||||
| LastUpdateDate: | 03/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | WINDROW | ||||||||
| AuthorizedOfficialFirstName: | ZACHARY | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8304267444 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | J8843 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0094LT | 01 | TX | BCBS GROUP | OTHER | 169422601 | 05 | TX | MEDICAID |