Provider Demographics
NPI:1508160367
Name:MICHELLE ZANIEWSKI M.D., P.A.
Entity Type:Organization
Organization Name:MICHELLE ZANIEWSKI M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZANIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-580-7401
Mailing Address - Street 1:17070 RED OAK DR
Mailing Address - Street 2:STE 309
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2619
Mailing Address - Country:US
Mailing Address - Phone:281-580-7401
Mailing Address - Fax:281-580-5665
Practice Address - Street 1:17070 RED OAK DR
Practice Address - Street 2:STE 309
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2619
Practice Address - Country:US
Practice Address - Phone:281-580-7401
Practice Address - Fax:281-580-5665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8379174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00SL57Medicare UPIN