Provider Demographics
NPI:1912013756
Name:BLAIK, ZIAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:
Last Name:BLAIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8330 MEADOW RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3767
Mailing Address - Country:US
Mailing Address - Phone:214-379-1100
Mailing Address - Fax:214-379-1101
Practice Address - Street 1:8330 MEADOW RD
Practice Address - Street 2:SUITE 204
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3767
Practice Address - Country:US
Practice Address - Phone:214-379-1100
Practice Address - Fax:214-379-1101
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK68142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145599002Medicaid
TXB58998Medicare UPIN
TX8F4203Medicare PIN
TX8F4203Medicare PIN