Healthcare Provider Details

I. General information

NPI: 1548570021
Provider Name (Legal Business Name): ALECIA A. ZALOT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6711 S NEW BRAUNFELS AVE STE. 100
SAN ANTONIO TX
78223-3005
US

IV. Provider business mailing address

6711 S NEW BRAUNFELS AVE STE. 100
SAN ANTONIO TX
78223-3005
US

V. Phone/Fax

Practice location:
  • Phone: 210-532-8811
  • Fax: 210-531-8172
Mailing address:
  • Phone: 210-532-8811
  • Fax: 210-531-8172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number34917
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: