Provider Demographics
NPI:1467698332
Name:ZIVALJEVIC, NIKOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIKOLA
Middle Name:
Last Name:ZIVALJEVIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12230 COIT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2322
Mailing Address - Country:US
Mailing Address - Phone:214-252-7039
Mailing Address - Fax:214-252-7025
Practice Address - Street 1:12230 COIT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2322
Practice Address - Country:US
Practice Address - Phone:214-252-7039
Practice Address - Fax:214-252-7025
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254109207X00000X
TXP8333207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery