MEDICARE: DR. WASIQ A ZAIDI 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	2084P0800X	Psychiatry Physician	21519	OK
2	2084P0800X	Psychiatry Physician	M7783	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00682088	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8AV060	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1710920715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WASIQ A ZAIDI MD

Provider Business Mailing Address
First Line	:	PO BOX 152555
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-8555
Country	:	US
Telephone Number	:	817-200-6680
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 S COOPER ST # 131
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4447
Country	:	US
Telephone Number	:	817-200-6680
Fax Number	:	817-200-6731

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	06/29/2021

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