Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 21664 | TX |
NPI | 1013015221 |
---|---|
Provider Name | Dr. Scott Allen Schwartz |
First Address | San Antonio, TX 78254-2336 |
Second Address | San Antonio, TX 78229-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 16/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1634811 | UNITED CONCORDIA (01) | |
16624502 | CIDC DENTAL (01) | |
166245401 | (05) | TX |
88D945 | BLUE CROSS BLUE SHIELD (01) |