Reem Razeq, PA
Individual provider Active NPI Physician Assistant · Shavano Park, TX
NPI 1770057739 · NPPES record last updated Apr 30, 2025
Key facts
- NPI
- 1770057739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA12334 (TX)
- Practice address
- 3503 Paesanos Pkwy Ste 201
Shavano Park, TX 78231-1225 - Phone
- (210) 504-3650
- Fax
- (210) 519-3045
- NPI assigned
- Jan 13, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Adam Bruggeman MD PLLC
Practice addresses (Care Compare)
3619 Paesanos Pkwy
Suite 302
San Antonio, TX 78231-1259
Phone (210) 802-4662
Hospital & facility affiliations
- Legent Orthopedic + Spine
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190320001075 | TX | Practitioner - Physician Assistant | 6800136300 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12334 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adam Bruggeman MD PLLC | Physician Assistant | Current |
Accepting new patients |
| Adam Bruggeman MD PLLC | Current |
Accepting new patients |
Locations
20770 US Highway 281 N
San Antonio, TX 78258
Phone (210) 366-9906
3619 Paesanos Pkwy
Ste 10
San Antonio, TX 78231
Phone (210) 399-4836
3619 Paesanos Pkwy
Ste 302
Shavano Park, TX 78231
Phone (210) 469-3830
Interoperability endpoints
- frankkkuwamuraiiimd.reemrazeq@130038.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12334 | TX | Yes |
Addresses
Primary practice location
3503 Paesanos Pkwy Ste 201
Shavano Park, TX 78231-1225
Mailing address
3503 Paesanos Pkwy Ste 201
San Antonio, TX 78231-1225
Phone (210) 589-7386
Other providers in Shavano Park, TX
- Oordt Therapeutic Services, Inc
- Other Side of Treatment, PLLC
- Stacy Phillippe Rauch
- Delbert E Rainosek
- Peter E Ramirez
- Reddy Dental Dba PA
- Nukala H. Reddy
- Rehab Associates
- Theresa Reiff Garcia
- Fernando Reyes San Martin
All providers in Shavano Park, TX · Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.