Basic Information
| Provider Information | |||||||||
| NPI: | 1700827839 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAZA | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 65057 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782655057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107142447 | ||||||||
| FaxNumber: | 2109790814 | ||||||||
| Practice Location | |||||||||
| Address1: | 8019 S NEW BRAUNFELS | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782351019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109225556 | ||||||||
| FaxNumber: | 2109225557 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 05/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | L3447 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | L3447 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 8BB080 | 01 | TX | BLUE CROSS | OTHER | P00387208 | 01 | TX | RR MEDICARE | OTHER | 149224106 | 05 | TX | MEDICAID |