M. REZA MIZANI M.D. P.A. NPI 1275503393

NPI Information

NPI: 1275503393
Provider Name: M. REZA MIZANI, M.D., P.A.

Doing Business As: SOU

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 45D2195049

Address:
215 N SAN SABA STE 301
SAN ANTONIO, TX
ZIP 78207
Phone: (210) 212-8622
Get Directions

M. REZA MIZANI, M.D., P.A. is a nephrology internal medicine in San Antonio, TX. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. M. REZA MIZANI, M.D., P.A. NPI is 1275503393. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sou.

The provider's business location address is:

215 N SAN SABA STE 301
SAN ANTONIO, TX
ZIP 78207-164
Phone: (210) 212-8622
Fax: (210) 212-9197

The provider's authorized official is Veronica Marie Camarillo .
The authorized official title is Practice Manager and has the following contact phone number (210) 212-8622.

The CLIA number assigned to this NPI record is 45D2195049 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/23/2006 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	N7871	TEXAS	No
2	207RN0300X	Internal Medicine	Nephrology	L2477	TEXAS	Yes
3	208600000X	Surgery		G7417	TEXAS	No
4	213E00000X	Podiatrist		1596	TEXAS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	167911002	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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