Provider Demographics
NPI:1164535639
Name:ZALTSBERG, HAL STEPHEN (OD)
Entity Type:Individual
Prefix:
First Name:HAL
Middle Name:STEPHEN
Last Name:ZALTSBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4938 S STAPLES ST
Mailing Address - Street 2:#D11
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-3809
Mailing Address - Country:US
Mailing Address - Phone:361-986-8819
Mailing Address - Fax:361-986-0641
Practice Address - Street 1:4938 S STAPLES ST
Practice Address - Street 2:#D11
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-3809
Practice Address - Country:US
Practice Address - Phone:361-986-8819
Practice Address - Fax:361-986-0641
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3142TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E86LMedicare ID - Type Unspecified