Individual provider Active NPI

Bruce Daniel Zik, M.D.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1487879755
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G3930 Issued in TX
Practice address
12720 Hillcrest Rd
Suite 350
Dallas, TX 75230-2035
Phone
(972) 991-9900
Fax
(972) 991-8034
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G3930 TX Primary

Addresses

Primary practice location

12720 Hillcrest Rd
Suite 350
Dallas, TX 75230-2035

Mailing address

12720 Hillcrest Rd
Suite 350
Dallas, TX 75230-2035
Phone (972) 991-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120511000284 TX Practitioner - Psychiatry 0648433557 Practice locations: Dallas, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G3930TXMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1487879755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12720 HILLCREST RD",
            "address_2": "SUITE 350",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302035",
            "telephone_number": "972-991-9900",
            "fax_number": "972-991-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 HILLCREST RD",
            "address_2": "SUITE 350",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302035",
            "telephone_number": "972-991-9900",
            "fax_number": "972-991-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIK",
        "first_name": "BRUCE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "G3930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.