Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | H7262 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | H7262 | TX |
NPI | 1295745289 |
---|---|
Provider Name | Mr. Michael P Zeitlin |
First Address | San Antonio, TX 78239-1947 |
Second Address | San Antonio, TX 78222-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 18/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130772011 | (05) | TX |