Provider Demographics
NPI:1003849431
Name:ZIEBERT, CAROL LYNN (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LYNN
Last Name:ZIEBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 W 34TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1923
Mailing Address - Country:US
Mailing Address - Phone:512-459-6599
Mailing Address - Fax:512-459-8496
Practice Address - Street 1:1305 W 34TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1923
Practice Address - Country:US
Practice Address - Phone:512-459-6599
Practice Address - Fax:512-459-8496
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5262174400000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103413401Medicaid
TX103413401Medicaid
TX103413401Medicaid