Basic Information
| Provider Information | |||||||||
| NPI: | 1023128980 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZWALD | ||||||||
| FirstName: | ARLENE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24912 SINGLETON BEND EAST RD | ||||||||
| Address2: | |||||||||
| City: | MARBLE FALLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786543622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092933794 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1009 N GEORGETOWN ST | ||||||||
| Address2: | |||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786643289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122448480 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 09/17/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AP30007452 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 9650417 | 05 | WA | MEDICAID | 0212378 | 01 | WA | L&I | OTHER |