Healthcare Provider Details

I. General information

NPI: 1356368948
Provider Name (Legal Business Name): DANIEL W ZIEGLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W. MAGNOLIA AVENUE, SUITE 200
FORT WORTH TX
76104-4611
US

IV. Provider business mailing address

PO BOX 961205
FORT WORTH TX
76161-1205
US

V. Phone/Fax

Practice location:
  • Phone: 817-882-1193
  • Fax: 817-870-1602
Mailing address:
  • Phone: 817-740-8400
  • Fax: 817-870-1602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG0929
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberG0929
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: