Mazzare Medical, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K3331 Issued in TX

Legal business name

MAZZARE MEDICAL, PLLC

Practice address

5380 Old Bullard Rd Ste 600-357
Tyler, TX 75703-3607

Phone

(903) 245-3242

Fax

(877) 903-6204

NPI assigned

Jan 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mark Alan Mazzare, M.D.

Title

M.D./Owner

Phone

(903) 245-3242

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Cameron Roberts, FNP-C, ACNP

  • Critical Care Medicine Nurse Practitioner
  • Tyler, TX
  • NPI 1942228937
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1124390638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 OLD BULLARD RD STE 600-357",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033607",
            "telephone_number": "903-245-3242",
            "fax_number": "877-903-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 OLD BULLARD RD STE 600-357",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033607",
            "telephone_number": "903-245-3242",
            "fax_number": "877-903-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZZARE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "MAZZARE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "903-245-3242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299868401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laci Mayfield
• Brittney Mayhugh, RN
• Chrystal Mayo, LVN
• Hilay Jarman Mayo, SPEECH PATHOLOGIST
• Tera Mayo
• Mark A Mazzare, M.D.
• Brenda Tsehainzu Mbipeh, PHARMD
• MC Medical LLC
• Natalie Kay McAbee, O.D.
• James D McAndrew, M.D.

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.