Provider Demographics
NPI:1033181672
Name:SCHLUETER, JEFFREY MELVIN (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MELVIN
Last Name:SCHLUETER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 BIG SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-5763
Mailing Address - Country:US
Mailing Address - Phone:682-312-7339
Mailing Address - Fax:817-288-0958
Practice Address - Street 1:3109 6TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-3800
Practice Address - Country:US
Practice Address - Phone:682-312-7339
Practice Address - Fax:817-288-0958
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH65862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1156275-01Medicaid
TX1156275-01Medicaid
TX00N99VMedicare PIN