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General NPI Number Information
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NPI Number | 1275503393
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Entity Type | Organization
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Legal Business Name | M. REZA MIZANI, M.D., P.A.
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 215 N SAN SABA STE 301
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City | SAN ANTONIO
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State | TX
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Zip | 78207-3164
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Country | US
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Telephone | 210-212-8622
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Fax | 210-212-9197
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Provider Business Mailing Address
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Address Line | PO BOX 650002 DEPT 8286
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City | DALLAS
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State | TX
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Zip | 75265
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Country | US
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Telephone | 210-212-8622
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Fax | 210-212-9197
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | VERONICA MARIE JOHNSON
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Credential |
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Telephone | 210-212-8622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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