Provider Demographics
NPI:1891845681
Name:GOLDMAN, ZACHARY A (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:A
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:QUESTCARE PARTNERS
Mailing Address - Street 2:12221 MERIT DR #1610
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:214-217-1911
Mailing Address - Fax:
Practice Address - Street 1:QUESTCARE PARTNERS
Practice Address - Street 2:12221 MERIT DR #1610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251
Practice Address - Country:US
Practice Address - Phone:214-217-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN10161207P00000X
FLME101939207P00000X
TXN6317207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0011690-00Medicaid
GA663072140DMedicaid
TXP01021701OtherRAILROAD
FL1455QOtherBCBS
FL0011690-00Medicaid
TXTXB111260Medicare PIN
TX216315601Medicare PIN
FLCC444ZMedicare PIN