Provider Demographics
NPI:1477812121
Name:VIZUETE, JOHN AUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:AUSTIN
Last Name:VIZUETE
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 1:8550 DATAPOINT DR
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3440
Mailing Address - Country:US
Mailing Address - Phone:210-615-8308
Mailing Address - Fax:210-615-8313
Practice Address - Street 1:8550 DATAPOINT DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3440
Practice Address - Country:US
Practice Address - Phone:210-615-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8180207R00000X, 208M00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX365681102OtherCSHCN
TX365681101Medicaid
TX365681102OtherCSHCN