Provider Demographics
NPI:1194568881
Name:PICKUP, ZACHARY SCOTT (DMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:SCOTT
Last Name:PICKUP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 ESPIRTU SANTO DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-2283
Mailing Address - Country:US
Mailing Address - Phone:208-260-2777
Mailing Address - Fax:
Practice Address - Street 1:2030 HEIGHTS DR STE 2
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2185
Practice Address - Country:US
Practice Address - Phone:254-870-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist