MEDICARE: DR. KATRINA M. ZECCA M.D.

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	208000000X	Pediatrics Physician	L3568	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	370021046	OTHER	TX	RR/MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8F5576	OTHER	TX	BLUE SHIELD
3	1507048-02	OTHER	TX	CSHCN

General Provider Information

NPI Number	:	1346209616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATRINA M. ZECCA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:	254-724-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 ARBOR PARK DR
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-8196
Country	:	US
Telephone Number	:	254-680-1100
Fax Number	:

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	07/12/2024

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