=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275760613
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YULIYA P. ZEBROWSKI DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2009
-----------------------------------------------------
Last Update Date | 06/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5230 DE ZAVALA RD STE 225
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78249-1731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-696-0667
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25040 BLACK CRK
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78257-1100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-677-9174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 24671
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------