Individual provider Active NPI

William Lawrence Mize, M.D.

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1790776326
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01060385A Issued in IN
Practice address
400 Harborside Drive
Galveston, TX 77555-0001
Phone
(409) 747-7334
Fax
(409) 747-8579
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01060385A IN Primary

Addresses

Primary practice location

400 Harborside Drive
Galveston, TX 77555-0001

Mailing address

301 University Blvd
Provider Enrollment -- RT. 1022
Galveston, TX 77555-5302
Phone (409) 747-7334

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
I20080207000238 TX Practitioner - Pediatric Medicine 8527003920 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060385AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Pediatrics CurrentSince Apr 25, 2011 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

301 University Blvd
#1022
Galveston, TX 77555
Phone (409) 772-0848

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1790776326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "PROVIDER ENROLLMENT -- RT. 1022",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-747-7334",
            "fax_number": "409-747-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARBORSIDE DRIVE",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550001",
            "telephone_number": "409-747-7334",
            "fax_number": "409-747-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZE",
        "first_name": "WILLIAM",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01060385A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.