Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | H3973 | TX |
NPI | 1013907963 |
---|---|
Provider Name | Robert A Zajac |
First Address | San Antonio, TX 78295-1346 |
Second Address | San Antonio, TX 78258-4098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 17/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131416308 | (05) | TX |