MEDICARE: MARIA CAROLA ZALLES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZC0500X	Cytopathology Physician	044040	CT
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	101977	MO
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	044040	CT
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	102400	GA
5	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	01098530A	IN
6	207ZC0500X	Cytopathology Physician	102400	GA
7	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	04-23856	KS
8	207ZP0213X	Pediatric Pathology Physician	102400	GA

General Provider Information

NPI Number	:	1134183759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CAROLA ZALLES MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 SETON PKWY
Second Line	:	SETON MEDICAL CENTER WILLIAMSON, DEPT. OF PATHOLOGY
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-8000
Country	:	US
Telephone Number	:	203-676-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	11/21/2025

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