Individual provider Active NPI

Carlos Bazan III, M.D.

  • Diagnostic Radiology Physician
  • San Antonio, TX
National Provider Identifier
1083634794
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
F2547 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 450-6470
NPI assigned
Jul 19, 2006
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X F2547 TX
Diagnostic Radiology Physician 2085R0202X F2547 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

310 Tamworth Dr
San Antonio, TX 78213-1941
Phone (210) 265-8856

Other practice location 1

7703 Floyd Curl Dr
Department Of Radiology
San Antonio, TX 78229-3901
Phone (210) 567-6476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000140 TX Practitioner - Diagnostic Radiology 1557461365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Johns Hopkins University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F2547TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio Diagnostic Radiology CurrentSince Apr 20, 2009 Accepting new patients
American Health Imaging of Dallas, LLC CurrentSince Nov 14, 2019 Accepting new patients
American Health Imaging of Dallas LLC CurrentSince Jul 23, 2024 Accepting new patients
American Health Imaging of Dallas LLC CurrentSince Nov 14, 2019 Accepting new patients
American Health Imaging of Dallas LLC CurrentSince Dec 1, 2011 Accepting new patients
University of Texas Health Science Center at San Antonio Diagnostic Radiology CurrentSince Apr 20, 2009 Accepting new patients
American Health Imaging of Dallas LLC CurrentSince Dec 12, 2024 Accepting new patients
American Health Imaging of Dallas LLC CurrentSince Nov 14, 2019 Accepting new patients

Locations

2121 SW 36th St
San Antonio, TX 78237
Phone (210) 358-5100

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

4940 Charles Katz
San Antonio, TX 78229
Phone (210) 450-9700

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7703 Floyd Curl Dr
#7977
San Antonio, TX 78229
Phone (210) 292-0400

7979 Wurzbach Rd
San Antonio, TX 78229
Phone (210) 450-1000

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

8311 Ewing Halsell Dr
San Antonio, TX 78229
Phone (210) 562-8000

Interoperability endpoints

  • Direct secure messaging: cbazan24401@direct.utmsa.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1083634794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TAMWORTH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131941",
            "telephone_number": "210-265-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-450-6470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7703 Floyd Curl Dr",
            "address_2": "Department Of Radiology",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293901",
            "country_code": "US",
            "telephone_number": "210-567-6476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "TX",
            "license": "F2547",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "F2547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.