Provider Demographics
NPI:1518983873
Name:MAZZA, FRANCIS GERARD (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:GERARD
Last Name:MAZZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:GERARD
Other - Last Name:MAZZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9601 DEMONA CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-1681
Mailing Address - Country:US
Mailing Address - Phone:512-423-1732
Mailing Address - Fax:512-331-0713
Practice Address - Street 1:6001 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6112
Practice Address - Country:US
Practice Address - Phone:512-423-1732
Practice Address - Fax:512-328-7690
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4487174400000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129696404Medicaid
TX129696404Medicaid
TXC19005Medicare UPIN