Healthcare Provider Details

I. General information

NPI: 1700634086
Provider Name (Legal Business Name): MAXWELL ALLEN ZAPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 BRODIE LN STE 640
SUNSET VALLEY TX
78745-2551
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 512-580-3055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1391876
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: