Provider Demographics
NPI:1912921776
Name:LIEBERMAN, ZELIG H (MD)
Entity Type:Individual
Prefix:DR
First Name:ZELIG
Middle Name:H
Last Name:LIEBERMAN
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 1:3600 GASTON AVE
Mailing Address - Street 2:WADLEY TOWER, SUITE 958
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-826-6276
Mailing Address - Fax:214-826-6223
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 958
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-826-6276
Practice Address - Fax:214-826-6223
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC4905208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020053169OtherRR MEDICARE
TX104654204Medicaid
TX104654203Medicaid
TX8F8661OtherBCBS
TX8C6038Medicare PIN
TXB24383Medicare UPIN
TX8868B7Medicare PIN