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General NPI Number Information
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NPI Number | 1427010263
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Entity Type | Individual
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Provider Name | MARK S ZEBROWSKI O.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 05/10/2015
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Provider Practice Location Address
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Address Line | 1319 W STATE HIGHWAY 114 SUITE 320
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City | GRAPEVINE
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State | TX
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Zip | 76051-8617
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Country | US
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Telephone | 817-421-9705
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Fax | 817-421-9716
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Provider Business Mailing Address
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Address Line | 1319 W STATE HIGHWAY 114 STE 320
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City | GRAPEVINE
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State | TX
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Zip | 76051-8617
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Country | US
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Telephone | 817-421-9705
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Fax | 817-421-9716
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5764TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 5764TG
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License Number State | TX
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