Organization Active NPI

Louis D Zegarelli D O P a

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1306025614
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LOUIS D ZEGARELLI D O P A
Practice address
2225 Vatican LN
Dallas, TX 75224-4719
Phone
(214) 333-3393
Fax
(214) 333-0809
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Louis Dale Zegarelli, D.O.
Title
Physician/Medical Director
Phone
(214) 333-3393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2225 Vatican LN
Dallas, TX 75224-4719

Mailing address

2225 Vatican LN
Dallas, TX 75224-4719
Phone (214) 333-3393

Other identifiers 1

IdentifierTypeStateIssuer
146654201MedicaidTX

Other names 1

  • Kiest Park Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

2225 Vatican Ln
#C
Dallas, TX 75224
Phone (214) 333-3393

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341532800000",
    "number": "1306025614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 VATICAN LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752244719",
            "telephone_number": "214-333-3393",
            "fax_number": "214-333-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 VATICAN LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752244719",
            "telephone_number": "214-333-3393",
            "fax_number": "214-333-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUIS D ZEGARELLI D O P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2012-07-06",
        "status": "A",
        "authorized_official_last_name": "ZEGARELLI",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PHYSICIAN/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "214-333-3393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146654201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kiest Park Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.