Healthcare Provider Details

I. General information

NPI: 1407052590
Provider Name (Legal Business Name): ANNA ZELFOND FELDMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA ZELFOND M.D.

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BERGQUIST DR STE 1
LACKLAND A F B TX
78236-9908
US

IV. Provider business mailing address

2200 BERGQUIST DR STE 1
LACKLAND A F B TX
78236-9908
US

V. Phone/Fax

Practice location:
  • Phone: 210-292-7667
  • Fax:
Mailing address:
  • Phone: 210-292-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: