Provider Demographics
NPI:1487838611
Name:HEALTH BY DESIGN MEDICAL GROUP
Entity Type:Organization
Organization Name:HEALTH BY DESIGN MEDICAL GROUP
Other - Org Name:HEALTH BY DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASOZERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-265-6426
Mailing Address - Street 1:13409 GEORGE RD.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230
Mailing Address - Country:US
Mailing Address - Phone:210-492-8922
Mailing Address - Fax:
Practice Address - Street 1:13409 GEORGE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3064
Practice Address - Country:US
Practice Address - Phone:210-492-8922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty