Individual provider · NPI-1

Zachary Q. Botone, MD

Family Medicine · Grand Prairie, TX

NPI number1063614337
StatusActive
Last updated in NPPESJan 17, 2011

Details

NPI
1063614337
Entity type
Individual (NPI-1)
Name
Zachary Q. Botone
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 31, 2007
Last updated
Jan 17, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineN3510TXYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

2740 N. Hwy 360
Suite 100
Grand Prairie, TX 75050

Phone 972-606-8300 · Fax 972-606-4940

Mailing address

2740 N. Hwy 360
Suite 100
Grand Prairie, TX 75050

Phone 972-606-8300 · Fax 972-606-4940

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