Provider Demographics
NPI:1801885306
Name:MAZCURI, RIAZ S (MD)
Entity type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:S
Last Name:MAZCURI
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 1:6420 HILLCROFT ST
Mailing Address - Street 2:STE 403
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3103
Mailing Address - Country:US
Mailing Address - Phone:713-773-4505
Mailing Address - Fax:832-436-1669
Practice Address - Street 1:6420 HILLCROFT ST
Practice Address - Street 2:STE 403
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3103
Practice Address - Country:US
Practice Address - Phone:713-773-4505
Practice Address - Fax:713-773-3591
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG97722084P0804X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044314502Medicaid
TXD20761Medicare UPIN
TX044314502Medicaid
TXTXB164871Medicare PIN