Provider Demographics
NPI:1427069459
Name:MANN ZEBALLOS, MARGARET MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARIE
Last Name:MANN ZEBALLOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:423 TREELINE PARK
Mailing Address - Street 2:STE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2078
Mailing Address - Country:US
Mailing Address - Phone:210-640-9400
Mailing Address - Fax:210-640-9410
Practice Address - Street 1:250 E BASSE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-8408
Practice Address - Country:US
Practice Address - Phone:210-223-9617
Practice Address - Fax:210-472-2669
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7031207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01428683OtherRR MEDICARE
TX386043YLLWOtherMEDICARE
TX8ET482OtherBCBSTX
TX386043YLLWOtherMEDICARE
TX8L11982Medicare PIN
TX159188502OtherCSHCN