NPIMap

Organization Active NPI

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

  • 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.
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
Organization subpart
No

Authorized official

NPPES NPI Registry
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 connected to this organization with that name.

Practitioners 43

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

View all 43

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

300 N Teel Dr
Devine, TX 78016
Phone (830) 665-2876

3307 Bob Rogers Dr
Eagle Pass, TX 78852
Phone (830) 773-8878

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

7579 N Loop 1604 W
San Antonio, TX 78249

12011 State Highway 151
Ste 202
San Antonio, TX 78251
Phone (210) 265-8155

215 N San Saba
Ste 310
San Antonio, TX 78207

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

4911 NW Loop 410
Ste 104
San Antonio, TX 78229

17766 Verde Pkwy
Ste 205
Selma, TX 78154

17766 Verde Pkwy
Ste 150
Selma, TX 78154

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
IdentifierTypeStateIssuer
191158801MedicaidTX
0017PXOtherTXBCBS
P00440046OtherTXMEDICARE RAILROAD

Other names 1

NPPES NPI Registry
  • South Texas Renal Care Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2017.

{
    "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191158801",
            "state": "TX"
        },
        {
            "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"
        }
    ],
    "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.