Healthcare Provider Details

I. General information

NPI: 1568721397
Provider Name (Legal Business Name): ADAM ZACHARY NEUSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 01/04/2022
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 UNIVERSITY BLVD UTMB DEPARTMENT OF ORTHOPEDIC SURGERY
GALVESTON TX
77555-0165
US

IV. Provider business mailing address

444 S SAN VICENTE BLVD STE 603
LOS ANGELES CA
90048-4178
US

V. Phone/Fax

Practice location:
  • Phone: 409-747-5727
  • Fax: 409-747-5715
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberBP10044558
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA148265
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberQ9453
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: