1952463572 NPI number — MARGARET ZAK M.D.

Table of content: MARGARET ZAK M.D. (NPI 1952463572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952463572 NPI number — MARGARET ZAK M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAK
Provider First Name:
MARGARET
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1952463572
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 843
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAPEVINE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76099-0843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-337-3318
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 N PARK BLVD STE 114
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAPEVINE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76051-6900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
682-800-4008
Provider Business Practice Location Address Fax Number:
682-800-2690
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  M5005 , 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: 185920901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 185920902 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 185920903 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00394469 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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