Provider Demographics
NPI:1023185535
Name:SCHULTZ, MERCEDES (MD)
Entity Type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MERCEDES
Other - Middle Name:
Other - Last Name:GOEBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1016 N VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:PORT LAVACA
Mailing Address - State:TX
Mailing Address - Zip Code:77979-3000
Mailing Address - Country:US
Mailing Address - Phone:361-552-0325
Mailing Address - Fax:361-552-5926
Practice Address - Street 1:1016 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:PORT LAVACA
Practice Address - State:TX
Practice Address - Zip Code:77979-3000
Practice Address - Country:US
Practice Address - Phone:361-552-0325
Practice Address - Fax:361-552-5926
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4996207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J4674Medicare PIN