Provider Demographics
NPI:1336106913
Name:ZALETA, SARA L (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:ZALETA
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 1:874 ED HALL DR STE B-108
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1861
Mailing Address - Country:US
Mailing Address - Phone:972-932-5555
Mailing Address - Fax:972-932-5557
Practice Address - Street 1:874 ED HALL DR STE B-108
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1861
Practice Address - Country:US
Practice Address - Phone:972-932-5555
Practice Address - Fax:972-932-5557
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9029208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166475703Medicaid
TX8BW410OtherBCBS
TXH99690Medicare UPIN
TX8F20623Medicare PIN