Provider Demographics
NPI:1417938507
Name:ZUFLACHT, MICHAEL I (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:I
Last Name:ZUFLACHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E QUINCY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1922
Mailing Address - Country:US
Mailing Address - Phone:210-229-7242
Mailing Address - Fax:210-227-5092
Practice Address - Street 1:303 E QUINCY ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1922
Practice Address - Country:US
Practice Address - Phone:210-229-7242
Practice Address - Fax:210-227-5092
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD73792084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CR321OtherBCBSTX
TX102105701Medicaid
TXTXB120793Medicare PIN