Provider Demographics
NPI:1568660504
Name:GEORGE-ZIESER, SHALOMI MARGARET (DO)
Entity Type:Individual
Prefix:
First Name:SHALOMI
Middle Name:MARGARET
Last Name:GEORGE-ZIESER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHALOMI
Other - Middle Name:MARGARET
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:3410 CHALLIS TRAIL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 E. LOOKOUT DRIVE
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2902
Practice Address - Country:US
Practice Address - Phone:972-766-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM6630OtherTX LICENSE
NMA-1407-07OtherNM LICENSE
NM343727003Medicare PIN