Provider Demographics
NPI:1922118751
Name:BORYNACK, ZACHARY ALEXANDER (PHD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ALEXANDER
Last Name:BORYNACK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15051 ALSTONE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035
Mailing Address - Country:US
Mailing Address - Phone:214-263-7386
Mailing Address - Fax:
Practice Address - Street 1:4514 COLE AVE
Practice Address - Street 2:SUITE 807
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5412
Practice Address - Country:US
Practice Address - Phone:214-263-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32829103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0098MXOtherBCBS
267332OtherCOM PSYCH
TX579498OtherVALUE OPTIONS