Basic Information
| Provider Information | |||||||||
| NPI: | 1447655774 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZUNIGA | ||||||||
| FirstName: | MARCO | ||||||||
| MiddleName: | ANTONIO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 E SCHUSTER AVE BLDG 4 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799024672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9156429444 | ||||||||
| FaxNumber: | 9158008570 | ||||||||
| Practice Location | |||||||||
| Address1: | 2270 JOE BATTLE BLVD STE E-G | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799382609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9156429444 | ||||||||
| FaxNumber: | 9158008570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2014 | ||||||||
| LastUpdateDate: | 08/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN126782 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 806114 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LP0200X | AP126782 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.