Healthcare Provider Details
I. General information
NPI: 1083173173
Provider Name (Legal Business Name): PATRICIA COLLEEN ZIPEROVICH DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/18/2019
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13617 INWOOD RD STE 210
DALLAS TX
75244-4629
US
IV. Provider business mailing address
2801 LIVE OAK ST APT 4201
DALLAS TX
75204-5725
US
V. Phone/Fax
- Phone: 214-774-9500
- Fax:
- Phone: 830-688-2284
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 14051 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: