Individual
DR. SCOTT IRA REZNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BOULEVARD, DALLAS, TX 75390-7208
(214) 645-7700
(214) 645-2506
Mailing address
P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 645-7700
(214) 645-2506
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
M2459
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1764102-01
—
TX
01
—
1764102-02
CSHCN
TX
01
—
8S6325
BLUE SHIELD
TX
01
—
P00269402
RR/MEDICARE
TX
Enumeration date
03/31/2006
Last updated
10/01/2014
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