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General NPI Number Information
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NPI Number | 1013285758
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Entity Type | Individual
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Provider Name | ANTON VLADIMIR ZARYANOV DO
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Gender | Male
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 3142 HORIZON RD STE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-7815
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Country | US
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Telephone | 972-772-9600
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Fax | 972-772-9601
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Provider Business Mailing Address
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Address Line | 3142 HORIZON RD STE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-7815
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Country | US
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Telephone | 972-772-9600
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Fax | 972-772-9601
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 54285
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 5315058385
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 54285
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | R4350
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License Number State | TX
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