Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | BP10050372 | TX |
Y | 207P00000X | Emergency Physician | Q6134 | TX |
NPI | 1013328111 |
---|---|
Provider Name | Amanda Zelinski |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2014 |
Last Update Date | 15/08/2016 |