Provider Demographics
NPI:1265672414
Name:ZAFF, MIKE (OTR, PT)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:ZAFF
Suffix:
Gender:M
Credentials:OTR, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11520 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6605
Mailing Address - Country:US
Mailing Address - Phone:214-680-3669
Mailing Address - Fax:
Practice Address - Street 1:11520 N CENTRAL EXPY
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6605
Practice Address - Country:US
Practice Address - Phone:214-680-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-01
Last Update Date:2014-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172558225100000X, 225100000X
TX111414225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist