Provider Demographics
NPI:1790413276
Name:ZEIGLER, JOHN JEFFREY
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JEFFREY
Last Name:ZEIGLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-2252
Mailing Address - Country:US
Mailing Address - Phone:281-723-5329
Mailing Address - Fax:
Practice Address - Street 1:1700 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-2252
Practice Address - Country:US
Practice Address - Phone:281-723-5329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88432Medicaid