Provider Demographics
NPI:1255599627
Name:ZGALJARDIC, DENNIS JOSEPH (PHD, ABPP-CN)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JOSEPH
Last Name:ZGALJARDIC
Suffix:
Gender:M
Credentials:PHD, ABPP-CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 NASA PKWY STE 108C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3351
Mailing Address - Country:US
Mailing Address - Phone:409-789-1339
Mailing Address - Fax:
Practice Address - Street 1:1110 NASA PKWY STE 108C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3351
Practice Address - Country:US
Practice Address - Phone:409-789-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
TX32885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist