Provider Demographics
NPI:1376752113
Name:CHOE, ZACHIA (MD)
Entity Type:Individual
Prefix:
First Name:ZACHIA
Middle Name:
Last Name:CHOE
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 1:5310 GALAXIE RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-4502
Mailing Address - Country:US
Mailing Address - Phone:214-221-6362
Mailing Address - Fax:214-345-8784
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4426
Practice Address - Country:US
Practice Address - Phone:214-221-6362
Practice Address - Fax:214-345-8784
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191457401Medicaid
TXM6568OtherMEDICAL LICENSE
TX191457402Medicaid
TX8J7266Medicare PIN
TX8J7265Medicare PIN