Individual provider Active NPI

Lauren Eleanor Tarbox, M.D.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1154580223
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
N9653 Issued in TX
Practice address
4511 NW Loop 410
Suite 104
San Antonio, TX 78229-5124
Phone
(210) 614-7900
Fax
(210) 615-1211
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N9653 TX
Nephrology Physician 207RN0300X N9653 TX Primary

Addresses

Primary practice location

4511 NW Loop 410
Suite 104
San Antonio, TX 78229-5124

Mailing address

PO Box 504152
Saint Louis, MO 63150-4152
Phone (210) 212-8622

Other practice location 1

12315 Judson Rd Ste 208
Live Oak, TX 78233-3264
Phone (210) 614-7900

Other identifiers 1

IdentifierTypeStateIssuer
281456803MedicaidTX

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
I20110623000151 TX Practitioner - NephrologyPractitioner - Internal Medicine 1759569619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Texas Medical School at San Antonio, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
M Reza Mizani MD PAGroup PAC ID 5294709689, 28 clinicians

Practice addresses (Care Compare)

12970 Toepperwein Rd
Suite 102
Live Oak, TX 78233-4768
Phone (210) 664-0717

205 22ND St
Hondo, TX 78861-2520
Phone (210) 614-7900

215 N San Saba
Suite 301
San Antonio, TX 78207-3164
Phone (210) 212-8622

Hospital & facility affiliations

  • USRC Live Oak Dialysis Dialysis facility, Live Oak, TX, CCN 742561
  • Usrc Schertz Dialysis facility, Schertz, TX, CCN 672577
  • Usrc San Antonio Home Therapies Dialysis facility, San Antonio, TX, CCN 672718
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058
  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272
  • Pam Specialty Hospital of New Braunfels Inpatient rehabilitation facility, New Braunfels, TX, CCN 45TB06

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M. Reza Mizani, M.D., P.a. CurrentSince Jul 1, 2014 Accepting new patients
M. Reza Mizani, M.D., P.a. Nephrology CurrentSince Jul 1, 2014 Accepting new patients

Locations

1595 S Main St
Ste 107
Boerne, TX 78006
Phone (830) 815-5555

205 22nd St
Hondo, TX 78861
Phone (830) 426-2753

12970 Toepperwein Rd
Ste 102
Live Oak, TX 78233
Phone (210) 664-0717

12315 Judson Rd
Ste 208
Live Oak, TX 78233
Phone (210) 599-9570

14832 Main St
Lytle, TX 78052
Phone (830) 772-5784

8115 Datapoint Dr
Ste 200
San Antonio, TX 78229

343 W Houston St
Ste 609
San Antonio, TX 78205
Phone (210) 212-4595

215 N San Saba
Ste 301
San Antonio, TX 78207
Phone (210) 212-8984

4511 NW Loop 410
Ste 104
San Antonio, TX 78229

Interoperability endpoints

  • Direct secure messaging: lauren.tarbox@strcg.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1154580223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504152",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631504152",
            "telephone_number": "210-212-8622",
            "fax_number": "210-212-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 NW LOOP 410",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295124",
            "telephone_number": "210-614-7900",
            "fax_number": "210-615-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12315 Judson Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Live Oak",
            "state": "TX",
            "postal_code": "782333264",
            "country_code": "US",
            "telephone_number": "210-614-7900",
            "fax_number": "210-615-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARBOX",
        "first_name": "LAUREN",
        "middle_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N9653",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N9653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281456803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.