MEDICARE: ALEXIS LEE MIZE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	126149	TX

General Provider Information

NPI Number	:	1548124555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS LEE MIZE

Provider Business Mailing Address
First Line	:	230 CONWAY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1716
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 CONWAY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1716
Country	:	US
Telephone Number	:	517-525-3459
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2025
Last Update Date	:	12/13/2025

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Directions to “ ALEXIS LEE MIZE ” Practice Location

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