MEDICARE: DR. ZENAIDA P RACASA-ALIYAS 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	208000000X	Pediatrics Physician	E9926	TX

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

General Provider Information

NPI Number	:	1720160351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZENAIDA P RACASA-ALIYAS MD

Provider Business Mailing Address
First Line	:	2100 N MAIN ST
Second Line	:	SUITE 215
City	:	FORT WORTH
State	:	TX
Zip	:	76106-8570
Country	:	US
Telephone Number	:	817-625-4254
Fax Number	:	817-625-8451

Provider Business Practice Location Address
First Line	:	2106 N MAIN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76106-8511
Country	:	US
Telephone Number	:	817-625-4254
Fax Number	:	817-625-8451

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. ZENAIDA P RACASA-ALIYAS MD” Practice Location

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