Provider Demographics
NPI:1881690345
Name:BREEZE, SCOTT W (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:BREEZE
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 1:4911 SANDHILL DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5320
Mailing Address - Country:US
Mailing Address - Phone:281-238-7870
Mailing Address - Fax:
Practice Address - Street 1:22001 SOUTHWEST FWY STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-7001
Practice Address - Country:US
Practice Address - Phone:281-633-4940
Practice Address - Fax:281-633-4943
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3284207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200024146OtherRAIL ROAD MEDICARE
TXJ3284OtherSTATE LICENSE
TX123991507Medicaid
TX3354546OtherBLUE LINK
TXP01084626OtherRAILROAD
TX123991506Medicaid
TX123991505Medicaid
TX123991508Medicaid
TX5789173OtherAETNA PPO
TX0855346OtherAETNA HMO
TX123991504Medicaid
TX80310BOtherBCBS
TX200024146OtherRAIL ROAD MEDICARE
TX123991507Medicaid
TXP01084626OtherRAILROAD
TXTXB145352Medicare PIN
TX80310BOtherBCBS
TXF54546Medicare UPIN