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NPI 1003854894

NPI 1003854894 : DAVID R ZIMMERMANN PHD : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1003854894
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID R ZIMMERMANN PHD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/03/2006
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    Last Update Date     |    02/17/2010
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Provider Practice Location Address
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    Address Line         |    616 W RUSSELL PL 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78212-3658
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    Country              |    US
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    Telephone            |    800-257-8715
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    Fax                  |    800-819-1655
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Provider Business Mailing Address
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    Address Line         |    6915 ROBERT DIXON DR 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78749-2268
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    Country              |    US
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    Telephone            |    512-892-2196
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    Fax                  |    800-819-1655
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    23396
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    License Number State |    TX
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