Healthcare Provider Details

I. General information

NPI: 1609019272
Provider Name (Legal Business Name): DARIUS ALEXANDER BUZENAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 MEDICAL DR SUITE 500
SAN ANTONIO TX
78229-3342
US

IV. Provider business mailing address

4330 MEDICAL DR SUITE 500
SAN ANTONIO TX
78229-3342
US

V. Phone/Fax

Practice location:
  • Phone: 210-576-5306
  • Fax: 210-694-0645
Mailing address:
  • Phone: 210-576-5306
  • Fax: 210-694-0645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN2426
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: