Provider Demographics
NPI:1073366357
Name:TAPIA, ZACHARY DAVIS (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DAVIS
Last Name:TAPIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 AVONDALE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-6629
Mailing Address - Country:US
Mailing Address - Phone:636-544-8795
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD STE 3019B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8267
Practice Address - Country:US
Practice Address - Phone:314-509-5305
Practice Address - Fax:314-251-4454
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program