Provider Demographics
NPI:1952463572
Name:ZAK, MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:ZAK
Suffix:
Gender:F
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:PO BOX 843
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76099-0843
Mailing Address - Country:US
Mailing Address - Phone:940-337-3318
Mailing Address - Fax:
Practice Address - Street 1:220 N PARK BLVD STE 114
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6900
Practice Address - Country:US
Practice Address - Phone:682-800-4008
Practice Address - Fax:682-800-2690
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185920901Medicaid
TX185920902Medicaid
TX185920903Medicaid
TXP00394469OtherRAILROAD MEDICARE PIN
TXP00394469OtherRAILROAD MEDICARE PIN
TX185920901Medicaid
TX8J3520Medicare PIN