MEDICARE: DR. BRUCE DANIEL ZIK 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	2084P0800X	Psychiatry Physician	G3930	TX

General Provider Information

NPI Number	:	1487879755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE DANIEL ZIK M.D.

Provider Business Mailing Address
First Line	:	12720 HILLCREST RD
Second Line	:	SUITE 350
City	:	DALLAS
State	:	TX
Zip	:	75230-2035
Country	:	US
Telephone Number	:	972-991-9900
Fax Number	:	972-991-8034

Provider Business Practice Location Address
First Line	:	12720 HILLCREST RD
Second Line	:	SUITE 350
City	:	DALLAS
State	:	TX
Zip	:	75230-2035
Country	:	US
Telephone Number	:	972-991-9900
Fax Number	:	972-991-8034

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	06/03/2011

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