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General NPI Number Information
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NPI Number | 1376047837
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Entity Type | Individual
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Provider Name | MOEZ MITHANI MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 20079 STONE OAK PKWY STE 1245
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City | SAN ANTONIO
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State | TX
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Zip | 78258-6957
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Country | US
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Telephone | 210-545-0087
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Fax | 210-545-3455
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Provider Business Mailing Address
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Address Line | 20079 STONE OAK PKWY STE 1245
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City | SAN ANTONIO
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State | TX
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Zip | 78258-6957
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Country | US
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Telephone | 210-545-0087
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Fax | 210-545-3455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD61258608
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4373-320
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | V1351
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License Number State | TX
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