Provider Demographics
NPI:1912982018
Name:ZAGRODZKY, JASON DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:DENNIS
Last Name:ZAGRODZKY
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 1:4316 JAMES CASEY BLDG, C, SUITE 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-381-0170
Mailing Address - Fax:512-381-0171
Practice Address - Street 1:4316 JAMES CASEY BLDG, C, SUITE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-381-0170
Practice Address - Fax:512-381-0171
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4632207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129973712Medicaid
TXP01050560OtherRAILROAD MEDICARE
TX060057052OtherMEDICARE RAILROAD
TX129973719Medicaid
TX129973714Medicaid
TX129973711Medicaid
TX129973703Medicaid
TX129973707Medicaid
TX8CU397OtherBCBS
TX129973714Medicaid
TX89670NMedicare PIN
TXP01050560OtherRAILROAD MEDICARE
TX129973703Medicaid
TX129973711Medicaid
TX8L14995Medicare PIN
TXTXB128610Medicare PIN