Provider Demographics
NPI:1043263437
Name:SCHROEDER, GEORGE ERIC (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ERIC
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-4124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2900 S LOOP 256
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-6958
Practice Address - Country:US
Practice Address - Phone:903-731-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4698207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K9304OtherBCBS
TX8U4370OtherBCBS
TX154625108Medicaid
TX154625106Medicaid
TX8R9305OtherBCBS
TX154625110Medicaid
TXP00118956Medicare PIN
TX8B8888Medicare PIN
TX154625110Medicaid
TX8D7305Medicare PIN
TX8J7174Medicare PIN
TX8R9305OtherBCBS
TX8F1935Medicare PIN
TX8F5242Medicare PIN
TXP00327675Medicare PIN
TX8K9304OtherBCBS
TX8J7175Medicare PIN