Provider Demographics
NPI:1407741382
Name:MCPIKE, ZACKERY
Entity type:Individual
Prefix:
First Name:ZACKERY
Middle Name:
Last Name:MCPIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 SHERATON AVE APT 2218
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2174
Mailing Address - Country:US
Mailing Address - Phone:903-241-1886
Mailing Address - Fax:
Practice Address - Street 1:122 SHERATON AVE APT 2218
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-2174
Practice Address - Country:US
Practice Address - Phone:903-241-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT145987225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist