Provider Demographics
NPI:1841222346
Name:WIERZBICKI, DANIA A (MD)
Entity Type:Individual
Prefix:
First Name:DANIA
Middle Name:A
Last Name:WIERZBICKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5499 GLEN LAKES DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4300
Mailing Address - Country:US
Mailing Address - Phone:214-691-1330
Mailing Address - Fax:214-691-6405
Practice Address - Street 1:5499 GLEN LAKES DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4300
Practice Address - Country:US
Practice Address - Phone:214-691-1330
Practice Address - Fax:214-691-6405
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36736207K00000X
TXL8226207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ253679Medicaid
AZI10255Medicare UPIN
AZZ117638Medicare PIN