Healthcare Provider Details

I. General information

NPI: 1558473173
Provider Name (Legal Business Name): JAMIE J. ZABUKOVEC PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S LANCASTER RD VA NORTH TEXAS HCS PSYCHOLOGY SERVICE 116B
DALLAS TX
75216-7167
US

IV. Provider business mailing address

4500 S LANCASTER RD VA NORTH TEXAS HCS PSYCHOLOGY SERVICE 116B
DALLAS TX
75216-7167
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-0534
  • Fax: 214-857-0917
Mailing address:
  • Phone: 214-857-0534
  • Fax: 214-857-0917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00001832
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: