| Ziba Rezaee Md Pllc | |
|
1205 Ranch Road 620 S Lakeway TX 78734-6311 | |
| (512) 263-5100 | |
| (512) 263-5104 |
| Full Name | Ziba Rezaee Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1205 Ranch Road 620 S, Lakeway, Texas |
| Authorized Official Name and Position | Ziba Rezaee (SOLE PROPRIETOR) |
| Authorized Official Contact | 5122635100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ziba Rezaee Md Pllc 1205 Ranch Road 620 S Ste 201 Lakeway TX 78734-6311 Ph: (512) 263-5100 | Ziba Rezaee Md Pllc 1205 Ranch Road 620 S Lakeway TX 78734-6311 Ph: (512) 263-5100 |
| NPI Number | 1205342474 |
|---|---|
| Provider Enumeration Date | 12/22/2017 |
| Last Update Date | 06/20/2023 |
| Medicare PECOS PAC ID | 2668735507 |
|---|---|
| Medicare Enrollment ID | O20180406000800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205342474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ziba Rezaee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902066236 PECOS PAC ID: 5092983908 Enrollment ID: I20110720000553 |
| Provider Name | Ellis D. Doan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124280805 PECOS PAC ID: 6305016098 Enrollment ID: I20110907001536 |
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