Provider Demographics
NPI:1184815367
Name:KANZ, BRIAN NOLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:NOLAN
Last Name:KANZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24165 IH 10 W STE 123
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1160
Mailing Address - Country:US
Mailing Address - Phone:210-390-0008
Mailing Address - Fax:888-842-4234
Practice Address - Street 1:1931 ROGERS RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4614
Practice Address - Country:US
Practice Address - Phone:210-390-0008
Practice Address - Fax:888-842-4234
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0029078207X00000X
TXN7707207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX303298901Medicaid
4641188509OtherMYUTMB 4641188509
4641188509OtherMYUTMB 4641188509