Provider Demographics
NPI:1669489969
Name:ZELLER, TIMOTHY DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DAVID
Last Name:ZELLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 TIMMONS LN STE 135
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5926
Mailing Address - Country:US
Mailing Address - Phone:713-355-5343
Mailing Address - Fax:
Practice Address - Street 1:3100 TIMMONS LN
Practice Address - Street 2:SUITE 135
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5926
Practice Address - Country:US
Practice Address - Phone:713-355-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC5887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU25150Medicare UPIN
TX603496Medicare PIN