Provider Demographics
NPI:1245267434
Name:ZEIKUS, PRIYA SWAMY (MD)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:SWAMY
Last Name:ZEIKUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:DARSINI
Other - Last Name:SWAMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5130 POOL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4506
Mailing Address - Country:US
Mailing Address - Phone:903-463-2223
Mailing Address - Fax:903-463-2224
Practice Address - Street 1:5130 POOL RD STE 200
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4506
Practice Address - Country:US
Practice Address - Phone:903-463-2223
Practice Address - Fax:903-463-2224
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6969207N00000X, 207ND0101X
MA227423207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189306703Medicaid