Provider Demographics
NPI:1417931155
Name:RAIZNER, MICHAEL E (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:RAIZNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:STE 2021
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-790-9125
Mailing Address - Fax:713-790-1802
Practice Address - Street 1:16659 SOUTHWEST FWY
Practice Address - Street 2:STE 215
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2375
Practice Address - Country:US
Practice Address - Phone:281-265-2393
Practice Address - Fax:281-265-2341
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2008-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL5105207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173964101Medicaid
TX173964102Medicaid
TX173964102Medicaid
I31837Medicare UPIN
TX173964101Medicaid