Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | H7651 | TX |
N | 207ND0101X | MOHS-Micrographic Surgeon | H7651 | TX |
NPI | 1174612162 |
---|---|
Provider Name | Dr. Keith E Schulze |
First Address | Sugar Land, TX 77478-3875 |
Second Address | Sugar Land, TX 77478-3875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 27/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F49689 | (02) | TX |