Individual provider Active NPI

Paul D. Jantzi, M.D.

  • Allergy & Immunology Physician
  • Brenham, TX
National Provider Identifier
1114090867
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
L4007 Issued in TX
Practice address
2505 Stone Hollow Dr Ste 100
Brenham, TX 77833-5631
Phone
(979) 836-5582
Fax
(979) 251-7804
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L4007 TX
Allergy & Immunology Physician 207K00000X L4007 TX Primary

Addresses

Primary practice location

2505 Stone Hollow Dr Ste 100
Brenham, TX 77833-5631

Mailing address

PO Box 611
Brenham, TX 77834-0611
Phone (979) 836-5582

Other practice location 1

2540 Highway 71 S Ste 100
Columbus, TX 78934-9222
Phone (979) 836-5582

Other practice location 2

917 N Circle Dr
Sealy, TX 77474-3333
Phone (979) 836-5582

Other practice location 3

2 Saint Marks Pl Ste 110
LA Grange, TX 78945-1255
Phone (979) 836-5582

Other practice location 4

1605 Rock Prairie Rd Ste 218
College Station, TX 77845-8358
Phone (979) 485-9287

Other practice location 5

815 Highway 71 W Ste 1150
Bastrop, TX 78602-0319
Phone (979) 836-5582

Other practice location 6

317 E Hempstead St
Giddings, TX 78942-3307
Phone (979) 836-5582

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
I20050622001425 TX Practitioner - Allergy/ImmunologyPractitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Emergency Medicine 0840235503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Emergency Medicine, Internal Medicine, Pediatric Medicine
Education
University of Texas Medical School at Houston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1605 Rock Prairie Rd
Suite 218
College Station, TX 77845-8358
Phone (979) 485-9287

1720 Von Minden Rd
La Grange, TX 78945-2419
Phone (979) 836-5582

2505 Stone Hollow Dr
Suite 100
Brenham, TX 77833-5631
Phone (979) 836-5582

598 Cactus St
Giddings, TX 78942-1437
Phone (979) 836-5582

815 Hwy 71 W
Suite 1150
Bastrop, TX 78602-0319
Phone (979) 836-5582

917 N Circle Dr
Sealy, TX 77474-3333
Phone (979) 836-5582

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4007TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul D. Jantzi, M.D., P.a. Specialist CurrentSince Oct 1, 2006 Accepting new patients
Utmb Faculty Group Practice Past Accepting new patients
Charles Robert Gobert, MD, PLLC PastSince Apr 24, 2019 Accepting new patients
Camil I Kreit MD PA Past Accepting new patients
Teresa H. Kinsfather, D.O., P.a. PastSince Oct 8, 2012 Accepting new patients

Locations

815 Highway 71 W
Ste 1150
Bastrop, TX 78602
Phone (512) 321-1098

1203 S Austin St
Brenham, TX 77833

2505 Stone Hollow Dr
Ste 100
Brenham, TX 77833

2540 Highway 71 S
Ste 100
Columbus, TX 78934
Phone (979) 732-2376

317 E Hempstead St
Giddings, TX 78942
Phone (979) 212-5115

1720 Von Minden Rd
La Grange, TX 78945
Phone (979) 968-2700

2 Saint Marks Pl
Ste 110
La Grange, TX 78945
Phone (979) 242-2387

917 N Circle Dr
Sealy, TX 77474

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1114090867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 611",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778340611",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 STONE HOLLOW DR STE 100",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335631",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 Highway 71 S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "TX",
            "postal_code": "789349222",
            "country_code": "US",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "917 N Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Sealy",
            "state": "TX",
            "postal_code": "774743333",
            "country_code": "US",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Saint Marks Pl Ste 110",
            "address_purpose": "LOCATION",
            "city": "LA Grange",
            "state": "TX",
            "postal_code": "789451255",
            "country_code": "US",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1605 Rock Prairie Rd Ste 218",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778458358",
            "country_code": "US",
            "telephone_number": "979-485-9287",
            "fax_number": "979-251-7804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 Highway 71 W Ste 1150",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "TX",
            "postal_code": "786020319",
            "country_code": "US",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 E Hempstead St",
            "address_purpose": "LOCATION",
            "city": "Giddings",
            "state": "TX",
            "postal_code": "789423307",
            "country_code": "US",
            "telephone_number": "979-836-5582",
            "fax_number": "979-251-7804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANTZI",
        "first_name": "PAUL",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L4007",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "L4007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.