Provider Demographics
NPI:1366542300
Name:ZACHRIA, ANTHONY J (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:ZACHRIA
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 1:800 SCOTT AND WHITE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6440
Mailing Address - Country:US
Mailing Address - Phone:979-207-4000
Mailing Address - Fax:979-207-4562
Practice Address - Street 1:800 SCOTT AND WHITE DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6440
Practice Address - Country:US
Practice Address - Phone:979-207-4000
Practice Address - Fax:979-207-4562
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7270207RP1001X, 207RS0012X, 207RP1001X
IL036118424207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00273TOtherMEDICARE
IL212636OtherMEDICARE GROUP NUMBER
TXL7270OtherMEDICARE
IL05732097OtherBCBS GROUP NUMBER