NPIMap

Organization Active NPI

M. Reza Mizani, M.D., P.a.

Doing business as South Texas Renal Care Group

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1497813331
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
M. REZA MIZANI, M.D., P.A.
Doing business as
South Texas Renal Care Group
Practice address
215 N San Saba Ste 301
San Antonio, TX 78207-8101
Phone
(210) 212-8622
Fax
(210) 212-9197
NPI assigned
Dec 4, 2006
Last updated
Jul 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

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

Authorized official

Name
Mohammad Reza Mizani, M.D.NPI 1497757660
Title
President
Phone
(210) 212-8622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

215 N San Saba Ste 301
San Antonio, TX 78207-8101

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
0017PXOtherTXBCBS
P00440046OtherTXMEDICARE RAILROAD
191158801MedicaidTX

Other names 1

  • South Texas Renal Care Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
M Reza Mizani MD PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2011 E Houston St
Ste 101A
San Antonio, TX 78202
Phone (210) 226-1717

215 N San Saba
Ste 201
San Antonio, TX 78207
Phone (210) 547-3430

4911 NW Loop 410
Ste 104
San Antonio, TX 78229

8115 Datapoint Dr
Ste 104
San Antonio, TX 78229

17766 Verde Pkwy
Ste 205
Selma, TX 78154

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1497813331",
    "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": "215 N SAN SABA STE 301",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782078101",
            "telephone_number": "210-212-8622",
            "fax_number": "210-212-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. REZA MIZANI, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "MIZANI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-212-8622",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0017PX",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00440046",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191158801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Texas Renal Care Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Texas Renal Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.