Provider Demographics
NPI:1508811779
Name:ZIEGLSCHMID ADAMS, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ZIEGLSCHMID ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:ZIEGLSCHMID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:801 ROAD TO SIX FLAGS WEST STE 139
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012
Mailing Address - Country:US
Mailing Address - Phone:817-265-1356
Mailing Address - Fax:817-261-4309
Practice Address - Street 1:801 ROAD TO SIX FLAGS WEST STE 139
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012
Practice Address - Country:US
Practice Address - Phone:817-265-1356
Practice Address - Fax:817-261-4309
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N86FMedicare ID - Type Unspecified
TXF64477Medicare UPIN