Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | D4297 | TX |
NPI | 1033194287 |
---|---|
Provider Name | Jimmy D Schmidt |
First Address | Houston, TX 77030-4501 |
Second Address | Houston, TX 77090-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 20/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
099412101 | (05) | TX |
B88073 | (02) | TX |