Provider Demographics
NPI:1053562264
Name:DAVID ZAHALUK MD PLLC
Entity type:Organization
Organization Name:DAVID ZAHALUK MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ZAHALUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-542-1271
Mailing Address - Street 1:571 W MAIN ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3628
Mailing Address - Country:US
Mailing Address - Phone:972-221-3500
Mailing Address - Fax:972-221-3522
Practice Address - Street 1:571 W MAIN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3628
Practice Address - Country:US
Practice Address - Phone:972-221-3500
Practice Address - Fax:972-221-3522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty