Healthcare Provider Details

I. General information

NPI: 1114842143
Provider Name (Legal Business Name): TERI ZATOPEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 ABRUZZI ST
LEANDER TX
78641-5495
US

IV. Provider business mailing address

420 ABRUZZI ST
LEANDER TX
78641-5495
US

V. Phone/Fax

Practice location:
  • Phone: 512-940-8966
  • Fax:
Mailing address:
  • Phone: 512-940-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1091754
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: