Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | F3326 | TX |
NPI | 1376526251 |
---|---|
Provider Name | George Mark Schwartze |
First Address | Dallas, TX 75284-4658 |
Second Address | Waco, TX 76712-8897 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 14/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123816402 | (05) | TX |
B88181 | (02) |