Provider Demographics
NPI:1053531269
Name:ZACHARY R. WINDROW, MD, PA
Entity type:Organization
Organization Name:ZACHARY R. WINDROW, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:WINDROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-426-7444
Mailing Address - Street 1:1204 OAK LN
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-1009
Mailing Address - Country:US
Mailing Address - Phone:830-426-7444
Mailing Address - Fax:830-426-7468
Practice Address - Street 1:3200 AVENUE E
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-3534
Practice Address - Country:US
Practice Address - Phone:830-426-7444
Practice Address - Fax:830-426-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0094LTOtherBCBS GROUP
TX169422601Medicaid
TX169422601Medicaid