Provider Demographics
NPI:1376683292
Name:ZIELINSKI, TANYA ANN (MD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:ANN
Last Name:ZIELINSKI
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 1:315 W WALL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5284
Mailing Address - Country:US
Mailing Address - Phone:214-642-1588
Mailing Address - Fax:817-796-1256
Practice Address - Street 1:315 W WALL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5284
Practice Address - Country:US
Practice Address - Phone:214-642-1588
Practice Address - Fax:817-796-1256
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK54392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151751801Medicaid
H64372Medicare UPIN
TX8126B7Medicare ID - Type Unspecified