Provider Demographics
NPI:1740490358
Name:ZBYLOT, PHILIP LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:LAWRENCE
Last Name:ZBYLOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 FM 3237
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-5510
Mailing Address - Country:US
Mailing Address - Phone:512-847-9688
Mailing Address - Fax:
Practice Address - Street 1:801 FM 2325
Practice Address - Street 2:STE B
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5057
Practice Address - Country:US
Practice Address - Phone:512-847-9688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE29622083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine