1497933865 NPI number — STEVEN C. ZIELINSKI, M.D., P.A.

Table of content: (NPI 1497933865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497933865 NPI number — STEVEN C. ZIELINSKI, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEVEN C. ZIELINSKI, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TEXAS SPINE & NEUROSURGERY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497933865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4515 LAKE SHORE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WACO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76710-1814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-732-3987
Provider Business Mailing Address Fax Number:
254-732-3823

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 W. HWY. 6
Provider Second Line Business Practice Location Address:
SUITE 430
Provider Business Practice Location Address City Name:
WACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76712-3793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-732-3987
Provider Business Practice Location Address Fax Number:
254-732-3823
Provider Enumeration Date:
02/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ZIELINSKI
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
254-732-3987

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  M6475 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: M6475 . This is a "TEXAS MEDICAL LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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