Healthcare Provider Details

I. General information

NPI: 1447795646
Provider Name (Legal Business Name): SAYENA AZARBAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2016
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BROOKLYN AVE STE 120
SAN ANTONIO TX
78212-4816
US

IV. Provider business mailing address

1200 BROOKLYN AVE STE 120
SAN ANTONIO TX
78212-4816
US

V. Phone/Fax

Practice location:
  • Phone: 210-271-7266
  • Fax: 210-226-8411
Mailing address:
  • Phone: 210-271-7266
  • Fax: 210-226-8411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number55446
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberS9259
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: