Provider Demographics
NPI:1033362173
Name:ZEBALLOS HEALTHCARE
Entity Type:Organization
Organization Name:ZEBALLOS HEALTHCARE
Other - Org Name:INTERVENTIONAL SPINE AND PAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:P
Authorized Official - Last Name:ZEBALLOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-345-5756
Mailing Address - Street 1:12221 MERIT DR STE 620
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3222
Mailing Address - Country:US
Mailing Address - Phone:214-506-2612
Mailing Address - Fax:972-681-8727
Practice Address - Street 1:17051 DALLAS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-7105
Practice Address - Country:US
Practice Address - Phone:214-888-3900
Practice Address - Fax:214-888-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7083350001OtherNSC-DME
TX0081RXOtherBCBS
TXOA3361Medicare PIN