Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | E-10709 | AR |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | L7877 | TX |
NPI | 1578573325 |
---|---|
Provider Name | Lesley Ann Schmitz |
First Address | Fort Worth, TX 76109-1889 |
Second Address | Fort Smith, AR 72916-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198638201 | (05) | TX |
8CA886 | BCBS (01) | TX |