Provider Demographics
NPI:1538210026
Name:PAUL D. JANTZI, M.D., P.A.
Entity type:Organization
Organization Name:PAUL D. JANTZI, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:JANTZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-836-5582
Mailing Address - Street 1:PO BOX 611
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-0611
Mailing Address - Country:US
Mailing Address - Phone:979-836-5582
Mailing Address - Fax:979-251-7804
Practice Address - Street 1:2505 STONE HOLLOW DR STE 100
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5631
Practice Address - Country:US
Practice Address - Phone:979-836-5582
Practice Address - Fax:979-251-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty