Provider Demographics
NPI:1255380028
Name:ZASIK, JOSEPH M (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:ZASIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6450
Mailing Address - Fax:
Practice Address - Street 1:619 S FLEISHEL AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2004
Practice Address - Country:US
Practice Address - Phone:903-606-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4072207RC0200X
PAOS004057L207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752616977180OtherTRICARE
TX75-2616977-123OtherTRICARE
290001397OtherPALMETTO GBA
PA01238401OtherCAPITAL BLUE CROSS
TX8BC074OtherBCBS OF TEXAS
PA0010727100003Medicaid
PA067826OtherHIGHMARK BLUE SHIELD
PA067826OtherHIGHMARK BLUE SHIELD
C28839Medicare UPIN