Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | N2289 | TX |
NPI | 1003017393 |
---|---|
Provider Name | Anna Burns Schroeder |
First Address | Fort Worth, TX 76112-3200 |
Second Address | Fort Worth, TX 76112-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 04/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP1-0026735 | INSTITUTIONAL PERMIT (01) |