Provider Demographics
NPI:1760828743
Name:SPRINGFIELD, ZACHARY ASHTON (ATP)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:ASHTON
Last Name:SPRINGFIELD
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EDDY
Mailing Address - State:TX
Mailing Address - Zip Code:76524-2537
Mailing Address - Country:US
Mailing Address - Phone:254-624-5717
Mailing Address - Fax:
Practice Address - Street 1:2000 W LOOP 340
Practice Address - Street 2:SUITE 105
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6860
Practice Address - Country:US
Practice Address - Phone:254-624-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT247200000X247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other