Provider Demographics
NPI:1639526528
Name:ZHELEZKOV, DARYA TRONINA (DPT)
Entity Type:Individual
Prefix:
First Name:DARYA
Middle Name:TRONINA
Last Name:ZHELEZKOV
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 OHIO DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5330
Mailing Address - Country:US
Mailing Address - Phone:972-985-2622
Mailing Address - Fax:972-985-2630
Practice Address - Street 1:1101 OHIO DR
Practice Address - Street 2:SUITE 110
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5330
Practice Address - Country:US
Practice Address - Phone:972-985-2622
Practice Address - Fax:972-985-2630
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1280020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX508639YWP3Medicare PIN